Association of Ego Defense Mechanisms with Electrolyte and Inflammation Marker Levels, Interdialytic Weight Gain, Depression, Alexithymia, and Sleep Disorders in Patients Undergoing Chronic Hemodialysis

Abstract

Background/Objectives: 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. Methods: 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. Results: There was a positive correlation between the affect displacement and dissociation with leukocyte levels (Spearman’s rho = 0.192, p = 0.02; rho = 0.165, p = 0.04), and between autistic fantasy and phosphorus levels (rho = −0.163, p = 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, p = 0.005, p = 0.022, p = 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, p < 0.001). Conclusions: The immature defense mechanisms were our research model’s strongest predictive factor of alexithymia (OR = 1.87, 95% CI 1.27 to 2.75).