Abstract
Purpose: To assess chronic obstructive pulmonary disorder (COPD) patients' defensive profile compared to healthy participants and to test whether specific ego defense mechanisms are associated with health-related quality of life (Hrolf) and self-reported dyspnoea severity.
Methods: In a cross-sectional study, we assessed in 80 patients with COPD and 80 age and gender-matched healthy participants, psychological distress (Hospital Anxiety and Depression Scale) and defense mechanisms/styles (Defense Style Questionnaire). Patients had their HRQOL evaluated with the St. George's Respiratory Questionnaire and underwent a comprehensive clinical evaluation with determination of functional parameters and dyspnoea severity.
Results: COPD patients presented higher scores in undoing, acting out, autistic fantasy, denial and splitting defenses compared to healthy-controls. Overall, patients showed a more immature (p=0.001) and/or neurotic (p=0.006) defensive profile. Higher scores of denial (p=0.044), somatization (p=0.009) and undoing (p=0.032) defenses were associated with poorer HRQoL, independently of the anticipated significant associations of clinical and psychological distress variables with impaired HRQoL. Somatization was strongly independently associated with more severe self-reported dyspnoea.
Conclusions: COPD patients exhibit a relatively immature and neurotic defensive profile. Pneumologists and consultation-liaison psychiatrists should consider the patients' underlying personality structure, especially somatization tendencies, since it is independently associated with HRQoL and dyspnoea severity.
- © 2011 ERS