Pojatić Đorđe, Miškić Blaženka, Jelinčić Ivana, Pezerović Davorin, Degmečić Dunja, Ćosić Vesna
Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
Department of Internal Medicine, General County Hospital Vinkovci, 32100 Vinkovci, Croatia.
J Clin Med. 2024 Dec 5;13(23):7415. doi: 10.3390/jcm13237415.
: Ego defense mechanisms are subconscious processes that help individuals cope with stressors from both external and internal realities. They are divided into three levels based on their adaptive function. Patients undergoing chronic hemodialysis are those who have been treated with this method for longer than three months. Only a few studies have examined the defense mechanisms in hemodialysis patients. Our study aimed to examine the association between ego defense mechanisms and alexithymia, depression, and sleep disorders, as well as clinical and biochemical variables, in a group of 170 hemodialysis patients. : We used the Defense Style Questionnaire-40, the Toronto Alexithymia Scale-26, the Pittsburgh Sleep Quality Index, and the Hamilton Depression Inventory as our analyses methods. Clinical and biochemical variables, along with interdialytic weight gain, were measured before the hemodialysis session. There was a positive correlation between the affect displacement and dissociation with leukocyte levels (Spearman's rho = 0.192, = 0.02; rho = 0.165, = 0.04), and between autistic fantasy and phosphorus levels (rho = -0.163, = 0.04). Depressive HD patients had higher levels of somatization, affect displacement, and splitting compared to the HD patients without depression (Man-Whitney U test, = 0.005, = 0.022, = 0.045). There were higher levels of immature defense mechanisms in the group of patients with alexithymia than in the group without alexithymia (Mann-Whitney U test, < 0.001). : The immature defense mechanisms were our research model's strongest predictive factor of alexithymia (OR = 1.87, 95% CI 1.27 to 2.75).
自我防御机制是潜意识过程，可帮助个体应对来自外部和内部现实的压力源。根据其适应功能，它们分为三个层次。接受慢性血液透析的患者是指接受这种治疗方法超过三个月的患者。只有少数研究探讨了血液透析患者的防御机制。我们的研究旨在探讨170名血液透析患者中自我防御机制与述情障碍、抑郁和睡眠障碍以及临床和生化变量之间的关联。
我们使用防御方式问卷-40、多伦多述情障碍量表-26、匹兹堡睡眠质量指数和汉密尔顿抑郁量表作为分析方法。在血液透析 session 前测量临床和生化变量以及透析间期体重增加。情感转移和分离与白细胞水平之间存在正相关（斯皮尔曼相关系数 rho = 0.192，P = 0.02；rho = 0.165，P = 0.04），自闭症幻想与磷水平之间存在正相关（rho = -0.163，P = 0.04）。与无抑郁的血液透析患者相比，抑郁的血液透析患者具有更高水平的躯体化、情感转移和分裂（曼-惠特尼U检验，P = 0.005，P = 0.022，P = 0.045）。述情障碍患者组中不成熟防御机制的水平高于无述情障碍患者组（曼-惠特尼U检验，P < 0.001）。
不成熟防御机制是我们研究模型中述情障碍的最强预测因素（OR = 1.87，95%置信区间1.27至2.75）。
