Fischer-Kern Melitta, Tmej Anna
Universitätsklinik für Psychoanalyse und Psychotherapie Medizinische Universität Wien Währinger Gürtel 18-20 A-1090 Wien Austria Universitätsklinik für Psychoanalyse und Psychotherapie - MedUni Wien.
Z Psychosom Med Psychother. 2019 Jun;65(2):162-177. doi: 10.13109/zptm.2019.65.2.162.
: The aim of this article is to outline the relevance of mentalization for the understanding of the dynamics and the psychotherapeutic treatment of depression, and to systematically review the literature on mentalization as it relates to the diagnosis of depression and the evaluation of depression treatment. : The first part of the article consists of an overview of the theory of mentalization and its relevance for depression and its treatment. For the second part, a literature research was conducted in Scopus and PubMed to retrieve and then manually select empirical studies on depression and mentalization, focusing on studies applying the Reflective Functioning Scale based on the Adult Attachment Interview. : For our review, 15 studies were selected. These suggest that severe chronic and/ or treatment resistant depression is related to more pronounced mentalizing deficits. With respect to psychotherapy process and outcome, mentalization is a specific focus of psychodynamic therapy approaches, and proves to be an important mediating and moderating variable. : Mentalization with its linkages to attachment theory offers rich possibilities for an in-depth understanding of the dynamics of depression and resulting mentalization based approaches to the treatment of the disorder. The small number of studies and their heterogeneous design allow only preliminary assumptions on the difference between severe, chronic and milder or episodic courses of depression with respect to mentalizing deficits and urge for further research.
本文旨在概述心理化对于理解抑郁症的动态变化及心理治疗的相关性，并系统回顾与抑郁症诊断及抑郁症治疗评估相关的心理化文献。本文第一部分对心理化理论及其与抑郁症及其治疗的相关性进行了概述。第二部分，在Scopus和PubMed数据库中进行文献检索，以获取并手动筛选关于抑郁症和心理化的实证研究，重点关注基于成人依恋访谈应用反思功能量表的研究。我们的综述选取了15项研究。这些研究表明，严重的慢性和/或难治性抑郁症与更明显的心理化缺陷有关。关于心理治疗的过程和结果，心理化是心理动力治疗方法的一个特定焦点，并被证明是一个重要的中介和调节变量。心理化与依恋理论的联系为深入理解抑郁症的动态变化以及由此产生的基于心理化的疾病治疗方法提供了丰富的可能性。研究数量较少且设计各异，这使得我们只能对严重、慢性与较轻或发作性抑郁症在心理化缺陷方面的差异做出初步假设，并迫切需要进一步研究。
