抑郁症的社会支持和防御方式研究

The comparative study on stress state, social support and defense style in patients with depression

目的 探讨抑郁症患者应激状态、应对行为、社会支持和防御方式的临床特征。方法 采用应对行为调查表、生活环境调查表、社会支持量表和防御方式问卷 ,对 4 1例抑郁症患者进行测试 ,并与 36例正常人进行对照研究。结果 (1)抑郁症组平均应激强度明显高于对照组 (P <0 .0 5 ) ,且抑郁症组面对应激时所采取的应对行为与对照组存在显著差异 ,主动娱乐、谋划对策、主动应付和工作投射因子分高 (P <0 .0 1) ,控制症状和消极发泄因子分低 (P <0 .0 1或P <0 .0 5 ) ;(2 )抑郁症组的社会支持满意度明显低于对照组 (P <0 .0 5 ) ,且抑郁症组对“亲属”的选用明显高于对照组 (P <0 .0 1) ;(3)抑郁症组中间型和不成熟型防御因子分高 (P <0 .0 1) ,投射、幻想、退缩因子 ,假性利他、隔离、交往倾向和消耗倾向因子分也明显高于对照组 (P <0 .0 1或P <0 .0 5 )。结论 (1)生活事件与抑郁症状的发生可能存在直接的关系 ,且抑郁症患者面对应激更多采取外射型应对方式 ;(2 )抑郁症患者的社会支持系统满意度差 ,且防御方式存在明显的不成熟倾向。

Objective: To explore the characters of stress state, social support and defense styles of depression patients. Methods: 41 depression patients were tested with Copying-behavior Scale, Environment of Life, Working Rating Scale, Social Support Rating and Defense Style Questionnaire. The result was compared with that of 36 normal controls. Results: (1)The average stress level of depression patients was significantly higher than that of normal controls (P≤0.05), when two groups faced the same stress, which indicated their coping styles were significantly different. (2) The level of satisfaction with social support in depression group was significantly lower than that in control group (P<0.05), and more depressive patients sought help from their relatives than the normal controls. (3) The result showed the greater use of immature defense mechanisms in depressive patients. The depressive patients scored significantly higher on such items as projection, fantasy, withdrawal, pseudo-altruism and so forth. Conclusion: (1) There may be an associaton between life event stress and depression disorders. Moreover, depressive patients are more likely to use the projective coping style when facing a stress. (2) The satisfaction with social support system in depressive patients is poor, and there is a trend toward the use of immature defense mechanisms in depressive patients.