目的 了解心理动力性心理治疗合并药物治疗对焦虑障碍患者防御方式的影响.方法 本研究26例符合DSM- IV诊断标准的焦虑障碍患者进行6个月的心理动力性心理治疗合并药物治疗,对患者进行治疗前后防御方式问卷(DSQ)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评定及比较.结果 6个月重测时HAMD(4.79±5.86)和HAMA(5.42±7.204)均较治疗前(17.88±11.01)、(19.67±8.35)明显降低(t1=6.143,t2=6.989,P＜0.000).6个月后不成熟防御方式的评分下降显著(t=2.17,P=0.04)；成熟型防御机制的评分增高显著(t=-4.84,P＜0.000);中间型防御机制评分下降显著(t=2.24,P=0.035).HAMA减分率与不成熟因子分下降率呈正相关(r=0.426,P=0.038).结论 心理动力性心理治疗合并药物治疗对焦虑障碍患者的焦虑和抑郁症状均有改善,并在改变症状的同时减少了不成熟防御机制的使用.心理动力性心理治疗合并药物治疗较单纯药物治疗更有助于焦虑症患者康复.%Objective To examine changes in defense styles when comparing phannacotherapy to psychodynamic therapy plus pharmacotherapy in anxiety disorder for 6 months. Methods Twenty — six patients that met DSM—IV criteria for anxiety disorder participated. Anxiety symptoms were evaluated with the HAMA,HAMD,and defense styles with the Defense Style Questionnaire. Results Two patients dropped. All symptoms decreased overtime and all defense styles changed over 6 month treatment. Correlation analyses found that scores of HAMA and HAMD were correlated with scores of immature defense style in the combined therapy. Conclusions combined therapy lead to decreased symptom and changes in defense styles in anxiety disorders. In psychodynamic therapy group,the change of immature defense styles is associated with patients' symptoms. Psychodynamic psychotherapy combined with drug treatment, compared to simple drug treatment, contribute to the better recovery of patients with anxiety disorders.
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