ABSTRACT

Attachment and mentalizing are central concepts in research on the etiology, course, and treatment of depression. The goal of this cross-sectional study was to clarify the unique value of these constructs in characterizing the presence, severity, and chronicity of depression. We examined 50 female inpatients suffering from Major Depressive Disorder (MDD) in comparison to 47 matched healthy controls regarding their attachment states of mind, mentalizing capacities, and clinical variables indicating depression severity and chronicity (e.g. illness duration, number of hospitalizations). In the group of depressed patients, unresolved attachment with regard to loss was significantly overrepresented. Dimensionally, patients were more disorganized and more insecure, whereas there was no difference on the dismissing-preoccupied dimension between the two groups. Mentalizing was significantly lower in patients than in healthy controls. Logistic regression analysis revealed attachment insecurity, mentalizing deficits, and unresolved loss to be incrementally relevant to predict MDD. Correlations with clinical parameters in the group of depressed patients showed positive associations between mentalizing deficits, attachment insecurity, and variables indicating illness chronicity. Our findings highlight the relevance of the inability to resolve or reappraise loss experiences in depressive states.

摘要

依恋和心理化是抑郁症病因、病程和治疗研究的核心概念。这项横断面研究的目的是阐明这些结构在描述抑郁症的存在、严重性和慢性病性方面的独特价值。我们检查了 50 名患有重度抑郁症 (MDD) 的女性住院患者与 47 名匹配的健康对照者的依恋心理状态、心智化能力以及表明抑郁严重程度和慢性期的临床变量（例如疾病持续时间、住院次数）。在抑郁症患者组中，与失去有关的未解决依恋明显过多。在维度上，患者更杂乱无章，更没有安全感，而两组之间的解雇-全神贯注维度没有差异。患者的心理化程度显着低于健康对照组。逻辑回归分析显示依恋不安全感、心理化缺陷和未解决的损失与预测 MDD 相关。抑郁症患者组与临床参数的相关性表明，心理缺陷、依恋不安全感和表明疾病慢性的变量之间存在正相关。我们的研究结果强调了无法解决或重新评估抑郁状态下的损失经历的相关性。和未解决的损失与预测 MDD 相关。抑郁症患者组与临床参数的相关性表明，心理缺陷、依恋不安全感和表明疾病慢性的变量之间存在正相关。我们的研究结果强调了无法解决或重新评估抑郁状态下的损失经历的相关性。和未解决的损失与预测 MDD 相关。抑郁症患者组与临床参数的相关性表明，心理缺陷、依恋不安全感和表明疾病慢性的变量之间存在正相关。我们的研究结果强调了无法解决或重新评估抑郁状态下的损失经历的相关性。