Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil.
Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Braz J Psychiatry. 2022 Nov 5;44(5):469-477. doi: 10.47626/1516-4446-2021-2214. Epub 2022 Jul 27.
To evaluate the impact of defense mechanisms at baseline on depressive symptoms after brief psychotherapies and after 6-months of follow-up among depressed patients with and without cluster B personality disorders (PDs).
This quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. The Millon Clinical Multiaxial Inventory-III was applied to assess PD, the Defense Style Questionnaire 40 was used to analyze defense mechanisms, and the Beck Depression Inventory was used to measure the severity of depressive symptoms. Adjusted analysis was performed by linear regression.
The final sample consisted of 177 patients diagnosed with major depressive disorder, of whom 39.5% had cluster B PDs. Immature defenses at baseline significantly predicted the persistence of depressive symptoms at post-intervention and at 6-months of follow-up only in patients with PDs.
In depressed patients with cluster B PDs, immature defenses predicted a poor response to brief therapies. The assessment of immature defenses at baseline can help identify patients at greater risk of poor therapeutic results and enable more appropriate treatment choices.
评估基线防御机制对伴有和不伴有 B 群人格障碍（PD）的抑郁患者接受简短心理治疗后和 6 个月随访时抑郁症状的影响。
本准实验研究嵌套在一项随机临床试验中，纳入了使用 Mini-国际神经精神访谈诊断为重度抑郁症的成年（18-60 岁）临床样本。Millon 临床多轴量表-III 用于评估 PD，防御风格问卷 40 用于分析防御机制，贝克抑郁量表用于测量抑郁症状的严重程度。采用线性回归进行调整分析。
最终样本包括 177 名被诊断为重度抑郁症的患者，其中 39.5%患有 B 群 PD。基线时不成熟的防御机制仅在 PD 患者中显著预测干预后和 6 个月随访时抑郁症状的持续存在。
在伴有 B 群 PD 的抑郁患者中，不成熟的防御机制预示着对简短治疗的反应不佳。基线时不成熟防御机制的评估可以帮助识别治疗结果较差风险较高的患者，并能做出更恰当的治疗选择。
