Mentalization and depressive symptoms in a clinical sample of adolescents and young adults

Martino Belvederi Murri; Gabriella Ferrigno; Simona Penati; Caterina Muzio; Giulia Piccinini; Marco Innamorati; Federica Ricci; Maurizio Pompili; Mario Amore

doi:10.1111/camh.12195

Mentalization and depressive symptoms in a clinical sample of adolescents and young adults

Child Adolesc Ment Health. 2017 May;22(2):69-76. doi: 10.1111/camh.12195. Epub 2016 Oct 25.

Authors

Martino Belvederi Murri¹, Gabriella Ferrigno¹, Simona Penati¹, Caterina Muzio¹, Giulia Piccinini¹, Marco Innamorati², Federica Ricci³, Maurizio Pompili³, Mario Amore¹

Affiliations

¹ Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy.
² Department of Human Sciences, European University of Rome, Rome, Italy.
³ Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

PMID: 32680319
DOI: 10.1111/camh.12195

Abstract

Background: Increasing evidence supports that mentalization deficits may have a role in the genesis of young age depression; however, few studies examined this issue in clinical populations.

Methods: Outpatients aged 14-21, suffering from various psychiatric disorders, were assessed using the Mentalization Questionnaire (MZQ), the Beck Depression Inventory (BDI), and the Childhood Trauma Questionnaire (CTQ), using data from age-matched healthy students for comparison. The relationship between CTQ, MZQ, and BDI scores was examined at the cross-sectional level, including mediation analyses, and longitudinally, in a subsample who underwent a psychotherapy intervention.

Results: Of 83 subjects, 33 (39.8%) had mentalization levels that were 1 standard deviation below those of comparison subjects. In the whole sample, the levels of mentalization were inversely associated with BDI (r = -.68, p < .001) and CTQ scores (r = -.30, p = .006). Moreover, MZQ scores mediated a large part of the effect of childhood trauma on depression (total effect: 10.6, 95% CI: 5.3, 15.9; direct effect: 6.5, 95% CI: 2.1, 10.8; indirect effect: 4.1, 95% CI: 1.5, 7.4). This effect was almost entirely explained by the Affect Regulation subscale. In patients re-evaluated after four sessions (n = 37), the decrease in BDI scores correlated with the increase in MZQ scores (r = .40, p = .02).

Conclusions: In a juvenile clinical sample, deficits of mentalization abilities were associated with the severity of depression and explained part of the depressogenic effects of childhood trauma.

Keywords: Adolescent; anxiety; childhood trauma; depression; mentalization; psychotherapy.