title: The use of defenses and physician health care costs: are physician health care costs lower in persons with more adaptive defense profiles?
abstract: BACKGROUND
  The objective of the present study was to determine if persons who use more adaptive defenses have lower physician health care costs compared to those who use less adaptive defenses.
  
  
  METHODS
  We randomly selected 667 persons from the 1995 population-based Nova Scotia Health Survey who completed a videotaped structured interview. Each interview was rated for typical defense use by the Defense-Q. We obtained physician health care costs for 3 months before and after the interview, as well as medical diagnoses and measures of psychological functioning.
  
  
  RESULTS
  A more adaptive defense profile significantly predicted lower future physician health care costs. These results were found when controlling for other psychosocial variables, before and after controlling for previous physician health care costs, and when testing only within a physically healthy subsample. Results of secondary analyses showed that a more adaptive defense profile was positively related to a number of psychosocial variables, such as nurse's rating of competence, lack of depressive symptoms, and days at work.
  
  
  CONCLUSIONS
  The adaptiveness of a person's defense use in managing affect is important in predicting physician health care costs as well as psychosocial functioning.
authors.affiliation: Department of Psychology, University of Saskatchewan, Saskatoon, Sask., Canada. micael.macgregor@usask.ca
authors.forename: Michael William
authors.initials: MW
authors.lastname: MacGregor
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: Paul
authors.initials: P
authors.lastname: Rowan
authors.forename: Cheryl
authors.initials: C
authors.lastname: Barksdale
authors.forename: David
authors.initials: D
authors.lastname: MacLean
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000175:diagnosis / Q000191:economics / Q000523:psychology; D005251:Fees, Medical / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009674:Nova Scotia; D010552:Personality Assessment / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D012017:Referral and Consultation / Q000191:economics* / Q000706:statistics & numerical data; D012803:Sick Role; D012917:Social Adjustment