• 대한불안의학회지
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• 제10권1호
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• pp.3-10
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• 2014

Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.

• 동의신경정신과학회지
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• 제24권spc1호
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• pp.55-62
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• 2013

Objectives : We will discuss the differences on EEG results of Post-traumatic embitterment disorder (PTED) and Major depressive disorder (MDD). Methods : We measured EEG on 21 sites (Fp1, Fpz, Fp2, F7, F3, Fz, F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1, Oz, O2) of PTED and MDD. Then, we compared the results. Results : There is a significant result of a beta band between PTED and MDD. Conclusions : We became aware of the differences on EEG results of PTED and MDD. This can be used as the basis of diagnosis.

• Journal of Korean Neurosurgical Society
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• 제63권4호
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• pp.477-486
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• 2020

Objectives : Due to recent developments and the wide application of percutaneous transforaminal discectomy (PTED) in China, we herein compare its clinical effects with microendoscopic discectomy (MED) for the treatment of lumbar disc herniation in terms of recurrence and revision rates. Methods : Six databases, namely, PubMed, EMBASE, Cochrane Library, Ovid, China National Knowledge Infrastructure and Wanfang, were searched by computer. The literature was screened according to inclusion and exclusion criteria, and the quality of the included literature was evaluated. After extracting the data from the papers, Review Manager 5.2 software (Cochrane Collaboration, Oxford, UK) was applied to analyze these data. Finally, sensitivity and publication bias analyses of the results were conducted. Results : A total of 12 studies consisting of 2400 patients were included in this meta-analysis. A comparison of PTED with MED revealed higher postoperative recurrence and postoperative revision rates for PTED (odds ratio [OR] recurrence, 1.60; 95% confidence interval [CI], 1.01 to 2.53; p=0.05 and OR revision, 1.77; 95% CI, 1.18 to 2.64, p=0.006). Conclusion : PTED has a number of advantages because it is a minimally invasive surgery, but its recurrence and revision rates are higher than MED. Therefore, MED should not be completely replaced by PTED.

• The Korean Journal of Pain
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• 제35권1호
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• pp.97-105
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• 2022

Background: Percutaneous transforaminal endoscopic discectomy (PTED) has been widely used in the treatment of lumbar degenerative diseases. Epidural injection of steroids can reduce the incidence and duration of postoperative pain in a short period of time. Although steroids are widely believed to reduce the effect of surgical trauma, the observation indicators are not uniform, especially the long-term effects, so the problem remains controversial. Therefore, the purpose of this paper was to evaluate the efficacy of epidural steroids following PTED. Methods: We searched PubMed, Embase, and the Cochrane Database from 1980 to June 2021 to identify randomized and non-randomized controlled trials comparing epidural steroids and saline alone following PTED. The primary outcomes included postoperative pain at least 6 months as assessed using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The secondary outcomes included length of hospital stay and the time of return to work. Results: A total of 451 patients were included in three randomized and two non-randomized controlled trials. The primary outcomes, including VAS and ODI scores, did not differ significantly between epidural steroids following PTED and saline alone. There were no significant intergroup differences in length of hospital stay. Epidural steroids were shown to be superior in terms of the time to return to work (P < 0.001). Conclusions: Intraoperative epidural steroids did not provide significant benefits, leg pain control, improvement in ODI scores, and length of stay in the hospital, but it can enable the patient to return to work faster.

• 대한불안의학회지
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• 제15권1호
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• pp.29-34
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• 2019

Objective : To determine predictors of posttraumatic stress disorder (PTSD) symptoms in burn injured patients and evaluate factors for identifying high risk group of PTSD. Methods : This study examined sixty one patients aged in the range of 19-65 years with burn injuries. All subjects completed self-assessment inventories about PTSD (The PTSD Check List for DSM-5. PCL-5), depression (Patient Health Questionnaire-9, PHQ-9), embitterment (Posttraumatic embitterment disorder self-rating scale, PTED scale) and meaning of life (Meaning in Life Questionnaire, MLQ). Stepwise multiple regression and ROC curve analysis were the tools used for analysis. Results : The results revealed higher depression, embitterment and lower presence of meaning in life predicted severe PTSD symptoms. ROC analysis indicated PTED scale and PHQ-9 were useful for discriminating high risk group of PTSD. Conclusion : The present study established that the need to consider embitterment, depression and meaning of life for alleviation and prevention of PTSD symptoms in burn patients.

• 대한불안의학회지
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• 제16권2호
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• pp.76-82
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• 2020

Objective : Previous studies have shown that depression, anxiety and embitterment are highly related to suicide. This study aims to investigate the mediating effect of embitterment between depression, anxiety and suicide. Methods : A total of 174 participants with depressive and anxiety disorders were evaluated with STAI-S, STAI-T, PHQ-9, PTED scale, SSI and suicide attempt history. A mediation analysis using bootstrapping was utilized in order to estimate the indirect effects of depression and anxiety on suicide through embitterment. Results : Embitterment significantly mediated the relationship between depression and suicidal ideation [b=0.291, 95% CI(0.18, 0.40)], and also it mediated the relationship between depression and suicide attempt [b=0.066, 95% CI(0.02, 0.16)]. Although a direct effect of anxiety on suicide attempt was not significant, but embitterment significantly mediated the relationship between anxiety and suicide attempt Conclusion : This suggests that embitterment may be a significant important factor to consider in the relationship between depression, anxiety and suicide. Understanding the mediating role of embitterment on suicide may helpful to prevent suicide.

• 콘크리트학회지
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• 제8권2호
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• pp.139-150
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• 1996

본 연구의 목적은 프리캐스트 콘크리트(PC) 대형판 구조물의 축소모델 제작 및 실험기법에 관한 정보을 제공하는 것이다. 적용된 축소율은 1/5이며, 4가지의 실험이 수행되었다. : 모델 콘크리트와 모델 철근의 재료실험, 수평접합부의 압축실험, 수직접합부의 전단실험, 2층 부분구조물의 정적 주기 실험, 이들 실험결과를 기초로 다음의 결론을 도출하였다. : (1)모델 콘크리트는 일반적으로 예상보다 압축강도가 크게 나타났다. (2)모델 철근은 진공관을 사용하지 않고 열처리를 할 경우 연성의 저하를 보인다. (3)수평접합부와 수직접합부의 파괴모드는 실물크기와 모델이 거의 유사하였으나. 모델의 강도는 상사법칙에 의한 요구강도보다 크게 나타났다. (4) 실물크기와 유사하게 모델철근의 연성과 모델 콘크리트의 압축강도를 확보할 수 있다면, 1/5모델 부분구조물의 이력거동은 실물크리와 매우 근접되게 나타낼 수 있다.