[Post-traumatic embitterment disorder (PTED). Differentiation of a specific form of adjustment disorders].
Adaptation disorders are a heterogeneous group of mental disorders. Although they play a major role in clinical practice, are difficult to treat, and often lead to chronicity and disability, diagnostic algorithms are vague and scientific research is rare. Clinical practice has shown a subtype of adaptation disorder that is characterized primarily by lasting embitterment after exceptional though normal life events which violate basic beliefs. This disorder can be called post-traumatic embitterment disorder (PTED). A case vignette and results of a pilot study are reported. Critical life events were found to be job loss in 38%, conflicts at work in 24%, death of a loved one in 14%, familial strain in 14%, and other events in 10%. When reminded of the critical event, patients report feelings of embitterment (85.7%), sadness (81.0%), anger (76.2%), or helplessness (75.0%). When standardized assessments are made, they fulfill criteria of various comorbid disorders such as GAD (38.1%), depression (33.3%) and dysthymia (33.3%), agoraphobia (28.6%), or panic (19.0%). Of the patients, 81% said they avoid places which remind them of the critical events. Impairments were suffered in work (70%), leisure (65%), and familial relations (57.1%).
Linden
M
M
Forschungsgruppe Psychosomatische Rehabilitation an der Charité, der Abteilung für Verhaltenstherapie und Psychosomatik, Rehabilitationsklinik Seehof der BfA Teltow/Berlin. linden@zedat.fu-berlin.de
Schippan
B
B
Baumann
K
K
Spielberg
R
R
D000275:Adjustment Disorders / Q000175:diagnosis* / Q000523:psychology; D000328:Adult; D000786:Anger; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D004650:Employee Performance Appraisal; D005260:Female; D006380:Helplessness, Learned; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D010563:Personnel Turnover; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology; D010865:Pilot Projects; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology; D012934:Social Isolation; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology