Institute of Community and Family Psychiatry, Jewish General Hospital; and McGill University, Montreal, Québec, Canada.
J Nerv Ment Dis. 2020 Apr;208(4):261-268. doi: 10.1097/NMD.0000000000001112.
Treatment studies of major depression commonly focus on symptoms, leaving aside change in putative psychological risk factors. This pilot study examines the relationship between changes in eight depressive defenses and depressive symptoms. Twelve adults with acute recurrent major depression were given antidepressive medications and randomized to 20 sessions of either cognitive behavioral therapy or dynamic psychotherapy and followed for 1 year. Defenses were assessed using the Defense Mechanism Rating Scales (DMRS) and Defense Style Questionnaire (DSQ) at intake, termination, and 1-year follow-up. Depression improved highly significantly on both the Hamilton Rating Scale for Depression and Beck Depression Inventory, respectively, eight (67%) and nine (75%) patients attained recovery by 1 year. Depressive defenses improved significantly by termination (mean ES = 0.97; 95% confidence interval, 0.30-2.16), but retrogressed somewhat by 1 year. A mean of 12.17% (SD = 10.60) depressive defenses remained; only five subjects (50%) attained normative levels. Although causal relationships were not established, depressive defenses are promising candidates for mediating treatment effects on outcome of major depression.
治疗重性抑郁症的研究通常集中在症状上，而忽略了潜在的心理风险因素的变化。这项初步研究探讨了八种抑郁防御机制的变化与抑郁症状之间的关系。12 名患有急性复发性重性抑郁症的成年人接受抗抑郁药物治疗，并随机分为认知行为治疗或动态心理治疗 20 次，随访 1 年。在入组时、治疗结束时和 1 年随访时，使用防御机制评定量表（DMRS）和防御方式问卷（DSQ）评估防御机制。汉密尔顿抑郁量表（Hamilton Rating Scale for Depression）和贝克抑郁量表（Beck Depression Inventory）分别显示抑郁症状显著改善，分别有 8 名（67%）和 9 名（75%）患者在 1 年内康复。防御机制在治疗结束时显著改善（平均 ES = 0.97；95%置信区间，0.30-2.16），但在 1 年后有所倒退。抑郁防御机制平均仍有 12.17%（SD = 10.60）；只有 5 名受试者（50%）达到正常水平。尽管尚未建立因果关系，但抑郁防御机制是介导重性抑郁症治疗效果的有前途的候选因素。
