Predictive value of self-reported and observer-rated defense style in depression treatment.

This study explored the predictive value of observer-rated and self-reported
defensive functioning on the outcome of psychotherapy for the treatment of
depression. Defense styles were measured according to the Developmental
Profile (DP) and the Defense Style Questionnaire (DSQ) in 81 moderately
severely depressed patients. All patients were treated with Short-term Psychodynamic
Supportive Psychotherapy (SPSP).
At baseline, women appeared to have a more mature level of overall
defensive functioning. A lower level of defensive function was found in
patients with recurrent depressions. We also found a rather modest relationship
between self-reported and observer-rated defense.
Kemitted patients had a more mature overall defensive functioning on the
DP and the DSQ. In particular, patients with a symbiotic defense style
(giving up, apathetic withdrawal) were at risk for poor outcome.
This exploratory study provides further evidence of the relevance of
defense styles for depression. It suggests a differential predictive value of
separate defense levels, which may help to tailor psychotherapeutic strategies.