重鬱症個案自殺企圖與生活型態防 衛機轉相關性之探討

重鬱症個案自殺企圖與生活型態防 衛機轉相關性之探討

 研究背景：重鬱症病人的壓力因應與自殺企圖發生有關，國內研究著重在找出自殺高危險群重鬱症 個案，尚缺乏對於重鬱症個案面對生活情境壓力所使用的防衛機轉進行探討。

研究目的：（ 1 ）重 症有無自殺企圖於生活型態防衛機轉使用之差異。（鬰 2 ）了解重 症有無自鬰 殺企圖者於憂鬱嚴重程度之差異。（ 3 ）了解重 症個案憂鬱嚴重程度與生活型態防衛機轉之相關。鬰 研究方法：本研究設計為描述性、相關性研究，以北區某專科教學醫院及某醫學綜合醫院精神科的 門診、急診及急性病房為收案場所，經專科醫師診斷為重鬱症的個案為研究對象。樣本數共 145 人

，依過去兩週是否出現自殺企圖分為：重 症自殺企圖組鬰 42 人，重 症無自殺企圖組鬰 103 人。問 卷包含個人資料、生活型態防衛機轉量表和貝克憂鬱量表。

研究結果： (1) 在理性情緒的防衛 (Rationality/ Emotional Defensiveness; R/ED) 、理性的防衛 (R/ED - rationality defensiveness ; R/ED-r) 、情緒的防衛 (R/ED- emotional defensiveness; R/ED-e) 分數中，

重鬱症有自殺企圖組平均值高於重鬱症無自殺企圖組。在理性的防衛 (R/ED-rationality defensiveness

; R/ED-r) 分數上達邊緣性統計差異 (p=0.05) 。結果指出重鬱症無自殺企圖組傾向使用較多的理性防 衛機制。 (2) 在貝克憂鬱量表 (The Beck Depression Inventory; BDI) 分數方面，結果顯示重鬱症自殺 企圖組平均分數為重度憂鬱等級，而重鬱症無自殺企圖組為中度憂鬱等級。此結果達顯著的差異 (p

<0.001) 。結果說明重鬱症個案的自殺企圖與貝克憂鬱量表分數達到重度憂鬱等級有關。 (3) 貝克憂 鬱量表 (The Beck Depression Inventory; BDI) 與理性的防衛 (R/ED -rationality defensiveness ; R/ED-r )

、情緒的防衛 (R/ED- emotional defensiveness; R/ED-e) 、自我犧牲 (NH-self sacrifice; NH-ss) 呈現正 相關。結果說明重鬱症症狀嚴重度與面對生活情境壓力使用過多以上的防衛機制有關。

結論：憂鬱症狀嚴重度達重度為自殺企圖行為產生之主要因素。重鬱症的自殺企圖可能是由於在壓 力因應上理性防衛的減弱，而因此增加了自殺衝動性。

關鍵字：重 症、生活型態防衛機轉、憂鬱狀態。鬰

A Study of the Relationship Between Suicide Attempt and Lifestyle Defense Mechanisms in

Patients With Major Depressive Disorder

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Title of Thesis: A study of the relationship between suicide attempt and lifestyle defense mechanisms in patients with major d epressive disorder.

Institution: Graduate Institute of Nursing, Taipei Medical University Author: Hsing – Ling Chou

Thesis directed by: Fei - Hsiu Hsiao, RN, PhD, Associate Professor, College of Nursing, Taipei Medical University

Background: Major depressive disorder patients stress coping skill is association with suicide attempt.

The Purposes of the study: (1)To understand the differences in uses of lifestyle defense mechanisms in major depressive disor der patients with or without suicide attempt (2)To understand the differences in depression scale level in major depressive dis order patients with or without suicide attempt

(3) To understand the relationship between major depressive disorder patient’s depression scale level and lifestyle defense me chanisms.

Method: This study adopts describing association design.The patients was from emergency, outpatient department and acute ward in two teaching hospital in Taipei. Total sample size 145, according to with or without suicide attempt during past two w eeks; 42 sample in major depressive disorder patients with suicide attempt ; 103 sample in major depressive disorder patients without suicide attempt. Questionnaire include personal data, Lifestyle Defense Mechanisms Inventory and The Beck Depress ion Inventory.

Results: (1) In Rationality/ Emotional Defensiveness; R/ED, R/ED - rationality defensiveness ; R/ED-r, R/ED- emotional defe nsiveness; R/ED-e of mean scores , major depressive disorder patients with suicide attempt mean score is higher than major d epressive disorder patients without suicide attempt.(2) In major depressive disorder patients with suicide attempt of The Beck Depression Inventory mean score is severe level, and major depressive disorder patients without suicide attempt is mild level.

(3) The Beck Depression Inventory , R/ED-rationality defensiveness ; R/ED-r , R/ED- emotional defensiveness; R/ED-e and NH-self sacrifice; NH-ss are positive association.

Conclusion: Depression symptom in severe level is a major factors for suicide attempte. major depressive disorder patients wi th suicide attempt may due to rationality defensiveness reduce , and increase suicide impulsivity.

Key words: Major depressive disorder, Lifestyle Defense Mechanisms(LDM),The Beck Depression Inventory(BDI).