The effect of reflective functions and emotional expression on the treatment response with antidepressant-type drugs and side effects

In this study, we aimed to examine the relationship between sociodemographic data on antidepressant treatment response and side effects, reflective function, somatization, emotion regulation and social support. The study included 100 patients diagnosed with Major Depressive Disorder (MDD) or Generalized Anxiety Disorder (GAD), who applied to the psychiatry outpatient clinic, and 102 patients matched for age, gender, and education year as a healthy control group. Sociodemographic data form was given to the both groups and Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Reflective Functioning Questionnaire (RFQ-54), Somatosensory Amplification Scale (SSAS), Social Provision Scale (SPS) and the Interpersonal Emotion Regulation Questionnaire (IERQ) were applied to both groups. Udvalg for Kliniske Undersøgelser Side Effect Rating Scale (UKU-SERS) was applied to the patient group during the control examination. While the SSAS scores and the Reflective Functioning uncertainty (RFQu) subscale scores of the patient group were higher than the healthy controls, SPS total and all subscale scores were low (p<0.05). The SPS opportunity for nurturance, reliable alliance subscales, and total scores of the scale were lower in MDD patients than in GAD patients. GAD patients' total IERQ scores and perspective taking subscale scores were found to be higher than those of MDD patients (p<0.05). No difference was found between MDD and GAD in terms of UKU-SERS scores. The SPS reassurance of worth and opportunity for nurturance subscale scores of the patients who responded to the treatment were found to be higher than the patients who did not respond to the treatment. There was no difference between the patients who responded and did not respond to treatment in terms of other scales. According to the results of our study, people with MDD and GAD have a high probability of being deprived of social support, exaggerating their bodily sensations, and having problems in mentalization. In the evaluation processes of patients, it is interpreted that considering these deteriorations and improving the social support of the patients are important in terms of both the course of the diseases and the determination of treatment options. No correlation was found between the level of response to treatment and sociodemographic data and scale scores. Based on this result, it was evaluated that the role of biological variables on the treatment response may be more important. Keywords: Anxiety, depression, reflective functioning, social support, treatment response.