摘要
背景:经典心理动力学理论认为,特殊的防御方式可能和疾病或症状之间存在特定联系。国内大部分研究表明抑郁症患者心理防御方式存在明显的中间型和不成熟倾向。目的:了解肾移植前后维持性血液透析抑郁患者的心理防御方式以及心理防御方式与患者产生抑郁的关系。设计、时间及地点:问卷调查,于2007-01/2008-01在石河子大学医学院第一附属医院和第三附属医院完成。对象:选择同期石河子大学医学院第一附属医院和第三附属医院肾病科血透室收治的肾移植前后行血液透析治疗的90例患者作为调查对象。纳入标准:①行血液透析治疗3个月以上的终末期肾衰竭患者,前3个月内无透析方式的改变及外科手术史。②文化程度在小学以上,意识清晰,有一定交流能力,能理解并配合调查。③排除脑损伤、脑肿瘤者及有精神病史、人格障碍者。④取得受试者及其家属的同意。方法:采用问卷调查方式,包括zung抑郁自评量表、防御方式问卷两项。主要观察指标:患者发生抑郁情况。抑郁与非抑郁患者心理防御方式的比较。抑郁发生与心理防御方式的相关性。结果:发放问卷90份,84份内容完整、真实且没有缺项、漏项的问卷予以回收,有效率93.3%。84例患者抑郁发生率为69%。抑郁与非抑郁患者在不成熟防御机制及其所包括的投射、被动攻击、潜意显现、幻想、退缩因子,成熟防御机制及其所包括的压抑、幽默因子,中间型防御机制及其所包括的期望因子均分比较,差异均有显著性意义(t=-4.401^-2.270,t=2.521~5.408,P均<0.05)。患者发生抑郁与不成熟防御机制及其所包括的投射、被动攻击、潜患显现、幻想、分裂因子,中间型防御机制及其所包括的隔离、消耗倾向因子均呈显著正相关(r=0.219~0.288,P<0.05或0.01),与成熟防御机制及其所包括的幽默、升华、压抑因子呈显著负相关(r=-0.470^-0.317,P均<0.01)。结论:肾移植前后维持性血液透析抑郁患者多采用不成熟防御机制和中间型防御机制,而较少采用成熟防御机制。抑郁的发生与不成熟防御机制呈正相关,与成熟防御机制呈负相关。
BACKGROUND： In classic psychodynamics, specific defense style may associate with diseases or symptoms. Many domestic studies demonstrate that the defense style in depressive patients is intermediate and immature. OBJECTIVE： To understand the mental defense style in depressive patients with maintenance hemodialysis pre-and post-renal transplantation and explore the relationship of defense style with depressive production. DESIGN, TIME AND SETTING： The survey was performed at First Hospital and Third Hospital of Shihezi University Medical College from January 2007 to January 2008. PARTICIPANTS： Ninety patients who received maintenance hemodialysis treatment in the Department of Nephrology from the First Hospital and the Third Hospital of Medical College of Shihezi University were selected. Inclusive criteria included kidney failure patients at final stage with hemodialysis for 〉 3 months, showing no dialysis changes within 3 months and with no surgical treatment; at least receiving primary education with certain communication ability and cooperation capacity; with no brain injury, brain tumor, psychiatric history or personality disorder; with the informed consent. METHODS： All patients were investigated using questionnaire including SDS （Zung Self-Rating Depression Scale） and DSQ （Defensive Style Questionnaire）. MAIN OUTCOME MEASURES： Depression; mental defense style between depressive and non-depressive patients; correlation between depression and mental defense style. RESULTS： Ninety questionnaires were sent and 84 completely filled and valid ones were retrieved. The validity was 93.3%. Depression occurred in 69% of 84 maintenance hemodialysis patients. There were significantly differences between depressive patients and non-depressive patients in terms of immature defense styles such as projection, passive-aggression, acting out, fantasy, and withdrawal, mature defense styles such as humor, sublimation and intermediate defense style （t=-4.401 to -2.270, t=2.521-5.408, P 〈 0.05）. The depression was positively correlated with immature defense styles such as projection, passive-aggression, acting out, fantasy, and withdrawal （r=-0.219-0.288, P 〈 0.05 or 0.01） and negatively correlated with the mature defense styles such as humor, sublimation and intermediate between two groups （r=-0.470 to -0.317, P 〈 0.05）. CONCLUSION： Immature mechanism or intermediate mechanism instead of mature mechanism is used in hemodialysis patient preand post-renal transplantation. The production of depression is correlated positively with immature defensive mechanism, and negatively with mature defensive mechanism significantly.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第40期7901-7904,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
