A Cross-Sectional Study Of Defense Mechanisms In Patients Of Depressive Disorders With Co-Morbid Substance Use Disorder

Abstract

Background: Coping with stress, substance use, recovery or interventions for mental health disorders have shown to be related with type and pattern of defence mechanism used. Hence, the current study aims to determine the relation between defence mechanisms and substance use in patients with Depressive disorders. Materials and methods: A cross sectional analytical study was conducted on 84 patients in the department of Psychiatry of a tertiary care teaching hospital in Chennai. Those fulfilled the eligibility criteria of age 18-59 years and having depression were categorised into those using substance and those who do not use. Hamilton Depression Scale was used to assess the severity of depression and a shortened version of Defence Style Questionnaire (DSQ) was used to assess the defence mechanism. Ethical clearance was obtained from institutional ethical committee. Results: The study was conducted on a sample of 84 people with depression. The median (IQR) age of onset of the disease was 37 (32-44.7) years. The overall median depression score was 15 (11-18). The level of depression was significantly higher among substance users than non-users. Projection (7.0) followed by rationalisation (6.7) and regression (6.4) were the most common defence mechanisms among substance users with depression. Majority of males were using substance. The proportion of substance use was higher among those who had studied only up to school or lower, among labourers and people in lower socio-economic class than their counterparts. Conclusion: The study concludes that different pattern of defense mechanisms were used in patients with depression with and without substance use, Projection followed by Rationalisation were the most common defence mechanism among substance users with depression, whereas, Denial followed by Reaction formation and Idealization were the common defense mechanisms among depression without substance use group which would be useful in better understanding of patients and application in psychotherapy.