Defensive Functioning in Patients with Depressive Disorders: a Study Protocol for a Systematic Review and Meta-Analysis

SCOPO DEL LAVORO: The role of defensive functioning in understanding Depressive Disorders is supported (Calati et al., 2010); however, there is no updated comprehensive overview. In order to fill this gap, we have developed a Study Protocol for a Systematic Review and Meta-Analysis with the following research questions: (a) Do mature defenses, non-mature defenses, and Overall Defensive Functioning (ODF) scores differ between individuals diagnosed with Depressive Disorder and nonclinical control groups (i.e., without a psychiatric diagnosis)? (b) Do mature defenses, non-mature defenses, ODF scores change during a psychological intervention in patients diagnosed with Depressive Disorder? MATERIALI E METODI: The present protocol has been registered on PROSPERO (CRD42023442620). Primary research articles and grey literature exploring defensive functioning in Depressive Disorders with reliable measures will be searched on EBSCO/PsycINFO, Web of Science, and PubMed. Two independent reviewers will conduct the search and assess the quality of the included studies with the Newcastle-Ottawa Scale. Meta-analytic synthesis (SMD) and sensitivity analysis will be performed. The study will be conducted according with the PRISMA 2020 guidelines. RISULTATI: We expect: (a) Lower mature defenses, higher non-mature defenses, and lower ODF scores in individuals with Depressive Disorders in comparison to nonclinical control groups; (b) Higher mature defenses, lower non-mature defenses, and higher ODF scores over the course of a psychological intervention in patients with Depressive Disorders. CONCLUSIONI: Improving clinical understanding of defense mechanisms may foster therapeutic process with depressed patients (De Roten et al., 2021). Potential biases and gaps in the available literature will be addressed leading to research recommendations.