Defense mechanisms in endogenous depression

Abstract

Defense mechanisms may be directly related to psychiatric diagnoses. There is an association between depression and maladaptive defenses, especially, the immature defenses. The aim of this study was to evaluate the defense mechanisms used by endogenous and non-endogenous patients by comparing those used by controls. The sample was composed of 92 treatment-naive patients with major depressive disorder (MDD; 46 endogenous type and 46 non-endogenous type) and 40 controls. The diagnosis of MDD in each participating patient was confirmed by means of the Structured Clinical Interview for DSM-IV, Turkish version, conducted by trained interviewers. Endogeneity of depression was assessed with Newcastle Depression Diagnostic Scale. Defense mechanisms were evaluated by using the Defense Style Questionnaire 40. Immature defense mechanisms differentiated controls from all patients as well as they distinguished endogenous depressive patients from non-endogenous patients. The analyses indicated that endogeneity is characterized by passive-aggression, acting out, isolation, autistic fantasy, rationalization and somatization. Additionally, total scores of the immature defenses had a positive correlation with severity of depression in the endogenous group. The results of the present study showed evidence of some differences in defense mechanisms among endogenous depression and non-endogenous depression diagnoses, specifically the maintenance of a high immature defense style in endogenous depression patients when compared with non-endogenous depression patients.