Does defense style or psychological mindedness predict treatement response in major depression?

Background: The aim of this study was to define the impact of defense style and psychological mindedness (PM) on the prognosis of major depressive disorder (MDD) in patients treated with either fluoxetine (FLX) or short‐term psychodynamic psychotherapy (STPP) in a randomized comparative study. Metho...

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Published in:Depression and anxiety 2009-07, Vol.26 (7), p.689-695
Main Authors: Kronström, Kim, Salminen, Jouko K., Hietala, Jarmo, Kajander, Jaana, Vahlberg, Tero, Markkula, Juha, Rasi-Hakala, Helena, Karlsson, Hasse
Format: Article
Language:English
Subjects:
Adult
antidepressive agents
Cognition
Defense Mechanisms
depressive disorder
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - psychology
Depressive Disorder, Major - therapy
Female
Fluoxetine - blood
Fluoxetine - therapeutic use
Humans
major
Male
Psychotherapy, Brief - methods
Serotonin Uptake Inhibitors - blood
Serotonin Uptake Inhibitors - therapeutic use
therapy
Time Factors
Treatment Outcome
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Summary:Background: The aim of this study was to define the impact of defense style and psychological mindedness (PM) on the prognosis of major depressive disorder (MDD) in patients treated with either fluoxetine (FLX) or short‐term psychodynamic psychotherapy (STPP) in a randomized comparative study. Method: 50 patients with MDD received either STPP or FLX treatment for 16 weeks. The Hamilton Depression Rating Scale (HDRS) was the outcome measure completed at baseline and in the follow‐ups at 4‐ and 12‐months. Patients completed the Psychological Mindedness Scale (PMS) and the Defense Style Questionnaire at the baseline. Results: In the FLX group recovery measured by the decrease in the HDRS during the 4‐month follow‐up associated with baseline mature defense style (r=−.59, P=.015). There were no correlations between the PMS‐scores and the outcome measures in either treatment groups nor defense status and the outcome in the STPP group. Conclusion: Mature defense style predicts good response to FLX therapy in major depression. This association was not found in the psychotherapy group. The results may imply that patients with immature defenses benefit relatively more from brief psychotherapy than medication. PM measured by the PMS was not useful in predicting recovery in MDD. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.
ISSN:1091-4269
1520-6394
DOI:10.1002/da.20585