Repressive Coping Does Not Contribute to Anosognosia in First-Diagnosis Patients With Alzheimer Disease.
Anosognosia is common in patients with Alzheimer disease (AD) even in early stages. Although neural correlates and the impact of cognitive dysfunctions have been described, possible psychodynamic processes such as a repressive coping style as described in other illnesses, have not been examined. Our study aimed to examine possible psychological influence factors on illness perception embracing a repressive coping style and cognitive functions in AD patients in the diagnostic process. Fifty-four subjects with mild AD diagnosed in our memory clinic were enrolled. Anosognosia was evaluated using a patient-caregiver discrepancy rating. All patients underwent comprehensive neuropsychological testing. In addition, characteristics of a repressive coping style were assessed. In total, 79.6% of our patients showed a lack of awareness at least to some degree. 33.3% of the patients were classified as repressors. Repressors and nonrepressors did not differ in cognition, or the unawareness score. Multivariate regression analysis showed that repressive coping style did not significantly contribute to anosognosia, but that verbal memory and naming ability had a strong influence. Although our data indicate that a high proportion of patients with mild AD show characteristics of repressive coping, this possible defense mechanism had no influence on the awareness of illness-related deficits measured by caregiver patient discrepancy.
*Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf †Mathematical Institute, Heinrich Heine University, Düsseldorf ‡Medical Psychology and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital of Cologne, Cologne, Germany.
Sandra
S
Verhülsdonk
Christian
C
Lange-Asschenfeldt
Barbara
B
Höft
Holger
H
Schwender
Tillmann
T
Supprian
Florence
F
Hellen
Elke
E
Kalbe
D000223:Adaptation, Psychological / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000175:diagnosis* / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology*; D001364:Awareness / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012094:Repression, Psychology; D014706:Verbal Learning / Q000502:physiology