Abstract Injustice, breach of trust, and humiliation are social stressors which can result in embitterment, known to everybody and which has been described in the Bible (Cain and Abel) or by Aristotle in the Nicomachean Ethics. It has been discussed by several authors since the early days of psychiatric classification. In the textbook ‘Psychiatry’ by E. Kraepelin a full chapter is devoted to ‘querulant delusion’, named a reactive psychosis, which can be discriminated from endogenous psychosis or personality disorders. Core symptoms are embitterment, negativism, helplessness, self blame, unspecific somatic symptoms, phobic avoidance of persons or situations related to the event, intrusions, phantasies of revenge and aggression. Another name is ‘Posttraumatic Embitterment Disorder’ according to the leading emotion. This severe mental disorder has by and large been ignored over the years by health professionals. In ICD-11 the term embitterment is mentioned for the first time in the category ‘6B43 adjustment disorder’. Embitterment can be measured with the ‘Bern Embitterment Inventory (BVI)’ and the ‘Post-Traumatic Embitterment Self-rating Scale (PTED scale)’. Treatment must take into account the special features of embitterment including often aggressive rejection of help. A promising treatment approach is, to refer to wisdom psychology and transfer this in ‘wisdom psychotherapy’.

中文翻译：

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Querulant妄想和创伤后苦涩障碍

摘要 不公正、违背信任和羞辱是社会压力因素，可导致痛苦，众所周知，圣经（该隐和亚伯）或亚里士多德在尼各马可伦理学中对此有所描述。自精神病学分类的早期以来，几位作者就已经讨论过这个问题。在 E. Kraepelin 的教科书“精神病学”中，有一整章专门讨论“可发性妄想”，称为反应性精神病，可与内源性精神病或人格障碍区分开来。核心症状是苦涩、消极、无助、自责、非特异性躯体症状、对与事件相关的人或情况的恐惧回避、侵入、报复和侵略的幻想。根据主导情绪，另一个名称是“创伤后苦涩障碍”。多年来，卫生专业人员基本上都忽视了这种严重的精神障碍。在 ICD-11 中，术语“苦涩”在“6B43 调节障碍”类别中首次被提及。苦涩可以用“伯尔尼苦涩问卷（BVI）”和“创伤后苦涩自评量表（PTED 量表）”来衡量。治疗必须考虑到痛苦的特殊特征，包括经常积极拒绝帮助。一种有前途的治疗方法是，参考智慧心理学并将其转移到“智慧心理治疗”中。苦涩可以用“伯尔尼苦涩问卷（BVI）”和“创伤后苦涩自评量表（PTED 量表）”来衡量。治疗必须考虑到痛苦的特殊特征，包括经常积极拒绝帮助。一种有前途的治疗方法是，参考智慧心理学并将其转移到“智慧心理治疗”中。苦涩可以用“伯尔尼苦涩问卷（BVI）”和“创伤后苦涩自评量表（PTED 量表）”来衡量。治疗必须考虑到痛苦的特殊特征，包括经常积极拒绝帮助。一种有前途的治疗方法是，参考智慧心理学并将其转移到“智慧心理治疗”中。