[Suggestion of a new diagnostic category: posttraumatic embitterment disorder]

Psychological reactions to negative life events have been among the most interesting subjects to researchers for a long time. In recent years post traumatic stress disorder (PTSD), in particular, has been the focus of numerous studies. This disorder is defined as a reaction to an event that is accepted as traumatic by almost everyone, to an extraordinary life-threatening event, or to a disaster. Psychological reaction to events, which are not directly life threatening, is classified as adjustment disorder and is rarely diagnosed in clinical practice. As a result of experiencing such non-life threatening events, PTSD is claimed to be an adjustment disorder as well. Immigrants frequently report a depressive state in which physical symptoms are in the foreground accompanied by social withdrawal and diminished energy. Negative life events, which are not life threatening and are not experienced everyday, can impair mental health so that the above state may worsen and an immigrant may have a reduction in his performance at work. This state, which is accompanied by such symptoms as embitterment, feelings of injustice, repeated intrusive memories of critical events (injustice at work place, loss of a job, discrimination in a public office, etc.), phobic symptoms, and avoidance behavior towards the place or persons related to the event, might best be described by the term, posttraumatic embitterment disorder (PTED). This disorder, which was initially described in immigrants from East Germany following the fall of the Berlin Wall, and which does not exactly match the diagnostic criteria of adjustment disorder or PTSD, is presented in a case vignette and its differential diagnosis is discussed.