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Defense Mechanisms After Brief Cognitive-Behavior Group Therapy for Panic Disorder: One-Year Follow-Up

Heldt, Elizeth RN, PhD*†; Blaya, Carolina MD, MS*†; Kipper, Leticia MD, MS*†; Salum, Giovanni A.*†; Otto, Michael W. PhD; Manfro, Gisele G. MD, PhD*†

The Journal of Nervous and Mental Disease: June 2007 - Volume 195 - Issue 6 - p 540-543
doi: 10.1097/NMD.0b013e318064e7c4
Brief Report

Changes in defense mechanisms have been shown in long-term psychodynamic treatment. The aim of this study was to examine the changes that occurred after brief cognitive-behavior group therapy in the defense style of panic disorder patients that had failed to respond to pharmacotherapy. Forty-seven patients participated in the study and severity of panic disorder was evaluated by Clinical Global Impression. Defense mechanisms were evaluated by the Defense Style Questionnaire. Patients decreased the use of maladaptive defenses after cognitive-behavior group therapy, and the change in immature defenses was maintained at 1-year follow-up evaluation (p = 0.022). These modifications were associated with reduction of symptoms (F = 0.359; p = 0.047). These findings are consistent with the hypothesis that defense styles are malleable in short-term treatment and are, at least partially, symptom-state dependent.

*Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil; †Post-Graduate Program in Medical Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; and ‡Center for Anxiety Related Disorders, Boston University, Boston, Massachusetts.

Michael Otto, PhD, has served as a consultant for Organon and an advisory board member for Sanofi-Aventis and has received speaker support from Pfizer.

Send reprint requests to Elizeth Heldt, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350 Room 400N, 90035-903, Porto Alegre, Rio Grande do Sul, Brazil. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.