焦虑和抑郁障碍共病患者的防御机制研究

目的 :探讨焦虑和抑郁障碍共病防御机制的特点以及与焦虑障碍和抑郁障碍防御机制的差别。方法 :对 2 5例焦虑和抑郁障碍共病、 3 0例抑郁症、 2 0例焦虑症患者和 83例正常人分别测评防御方式问卷(DSQ)、汉密尔顿抑郁量表 (HAMD)和汉密尔顿焦虑量表 (HAMA)。结果 :共病组与正常对照组相比 ,较少使用被动攻击、抱怨、期望 ;较多使用退缩、躯体化、解除、否认 ;抑郁组与正常对照组相比 ,较少使用幽默、期望 ;较多使用解除、假性利他、隔离 ;焦虑组与正常对照组相比 ,较少使用抱怨、幽默 ;较多使用解除、同一化。共病组的掩饰因子得分与正常人无差异 ,但抑郁组和焦虑组的掩饰因子得分显著低于正常人。共病组仅HAMD评分与退缩呈显著正相关 ;抑郁组HAMA评分与解除、交往倾向呈显著正相关 ,与隔离呈显著负相关 ;焦虑组HAMD评分与躯体化、否认呈显著正相关 ,HAMA评分与反作用形成、理想化呈显著负相关。结论 :焦虑和抑郁障碍共病具有与单纯焦虑障碍和单纯抑郁障碍不同的防御方式 ,但尚不能肯定它是不同于后两者的第三种疾病

Defense Mechanism in Comorbid Anxiety and Depression

Objective: To investigate whether patients with comorbid anxiety and depression (CAD) have different defense to patients with anxiety or depression Method: 25 patients with CAD, 30 with depression, and 20 with anxiety were tested with DSQ (defense style questionnaire), HAMD and HAMA 83 normal controls were also tested with same instruments Results: Compared with normal control, patients with CAD had less passive aggression, complain, anticipation and more regression, somatization, undoing, and denial; patients with depression had less humor, anticipation, but more undoing, altruism and isolation; while patients with anxiety only had less humor or complain, but more undoing and affiliation Patients with CAD had no significant difference to normal controls in lying, but patients with anxiety or depression had less score in lying In CAD group, the mean score of HAMD had positive correlation with regression In depression group, there were positive correlation between score of HAMA and undoing, intercourse tendency, negative correlation between score of HAMA and isolation In anxiety group, the score of HAMD had positive correlation with somatization, denial, negative correlation with reaction formation, idealization Conclusion: Patients with CAD have different defense styles to patients with only anxiety or depression