惊恐障碍患者防御方式的对照研究

目的：探讨惊恐障碍患者的防御方式及其与焦虑抑郁、功能状况的关系。方法：采用防御方式问卷对47名伴或不伴广场恐怖的惊恐障碍患者和37名健康对照者评估其防御方式，同时以汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评估其焦虑抑郁状态，并以功能大体评定量表评估近一周的社交职业功能水平。结果：①惊恐障碍组不成熟防御方式总分、投射、分裂、退缩和躯体化得分高于对照组（P〈0．05）；中间型防御方式总分、理想化、假性利他、伴无能之全能和交往倾向得分高于对照组（P〈0．05）；惊恐障碍组成熟防御方式总分、幽默得分显著低于对照组（P〈0.001）；②惊恐患者的不成熟防御方式总得分与受教育程度呈负相关（r=-0．357，P〈0．05），交往倾向得分与功能大体评分呈负相关（r=-0．384，P〈0．01）.结论：惊恐障碍患者使用不成熟和中间防御方式增多，使用成熟防御减少。

The Defense Mechanisms Used by Chinese Panic Patients

Objective: To evaluate the defense mechanisms most frequently used by Chinese patients with panic disorder.Methods: Forty-seven panic patients with or without agoraphobia,and thirty-senven controls participated in the study.The Hamilton Depression Scale(HAMD,Hamilton Anxiety Scale(HAMA) and global assessment function(GAF) were applied to assess the severity of depression and anxiety symptoms and social and occupational function,respectively.Defensive Style Questionnaire(DSQ-88) was used to evaluate defense mechanisms.Results: Compared with controls,panic patients had higher scores in projection,splitting,regression,somatization and total scores of immature defenses and higher scores in idealization,pseudo-altruism,omnipotence-devaluation,attiliation and total scores of neurotic defenses(P<0.05).Panic patients had lower scores in humor and total scores of mature defenses(P<0.05).Total scores of immature defenses were negatively correlated to the degree of education,and scores of attiliation were negatively correlated to the higher scores of GAF(P<0.05).Conclusion: Patients with panic disorder use more immature and neurotic defenses but less mature defenses.