Defense mechanisms in patients with depressive disorders: a study protocol for a systematic review and meta-analysis

Introduction: Empirical evidence supports the role of defensive functioning in understanding depressive disorders (Calati et al., 2010; Di Giuseppe & Perry, 2021). Changes in defense mechanisms before and after interventions focused on psychopathological conditions are also observed (Babl et al., 2019; Perry et al., 2020). The present study protocol for a systematic review and meta-analysis aims at the following: (a) Does the defensive functioning change over a psychosocial intervention in patients with a Depressive Disorder diagnosis? (b) Does the defensive functioning differ between individuals with a Depressive Disorder diagnosis and control groups? Method: Original articles addressing the relationship between defensive functioning and depressive disorders will be searched on PsycInfo/APA EBSCO, Web of Science, and PubMed from inception to 31 March 2022. They will employ reliable and well-validated instruments assessing Depressive Disorders and defensive functioning. Two independent reviewers will conduct the search, and a third reviewer will be consulted in case of disagreements. A narrative review will be conducted. Meta-analytic synthesis (mean differences) and potential additional analyses (meta-regression and subgroup analyses) will be performed. PRISMA guidelines will be used in the present study. Discussion: Research supports the need for a more accurate understanding psychological functioning of depressed patients and estimating the changes in defensive functioning in this population (De Roten et al., 2021). Relevant implications will be addressed to promote the planning of individualized and patient-tailored interventions.