this study was designed to assess three groups of subjects ( normal subjects , patients with ocd and pd ) by the persian dsq-40 . the normal subjects included those individuals who did not have any psychiatric disorders , and did not take any psychotropic medications at the time of the study . patients with ocd or pd were outpatients diagnosed according to dsm iv criteria ( 3 ) , and were visited at the private offices of three academic psychiatrists . the study patients were evaluated before receiving any treatment for ocd or pd . then , to check the content validity , three psychoanalysts were given the copies of the persian version . they were asked to correlate the items to each defense . in order to obtain the experts opinion about the test , a form was designed which consisted all items as well as the corresponding defense mechanisms . the extent of each expert 's agreement with the item used to detect the defense mechanism was scored from 1 to 5 : one represented the expert 's complete disagreement , and 5 showed complete agreement . after the experts stated their opinion about the farsi version , they were provided with the original version of dsq-40 to comment on using the same method . this showed whether or not there was any conflict in their opinion about the farsi version and the original version . data on internal consistency and reliability of the farsi version of dsq-40 was also studied . data on the internal consistency , validity and reliability of the test are demonstrated in table 1 . performance of the persian version of dsq-40 statistical analysis was performed using spss version 16.0 for windows . independent sample t test was used to compare defense styles and mechanisms of patients with normal subjects ; the significance level was defined as p < 0.05 . this study was designed to assess three groups of subjects ( normal subjects , patients with ocd and pd ) by the persian dsq-40 . the normal subjects included those individuals who did not have any psychiatric disorders , and did not take any psychotropic medications at the time of the study . patients with ocd or pd were outpatients diagnosed according to dsm iv criteria ( 3 ) , and were visited at the private offices of three academic psychiatrists . the study patients were evaluated before receiving any treatment for ocd or pd . then , to check the content validity , three psychoanalysts were given the copies of the persian version . they were asked to correlate the items to each defense . in order to obtain the experts opinion about the test , a form was designed which consisted all items as well as the corresponding defense mechanisms . the extent of each expert 's agreement with the item used to detect the defense mechanism was scored from 1 to 5 : one represented the expert 's complete disagreement , and 5 showed complete agreement . after the experts stated their opinion about the farsi version , they were provided with the original version of dsq-40 to comment on using the same method . this showed whether or not there was any conflict in their opinion about the farsi version and the original version . data on internal consistency and reliability of the farsi version of dsq-40 was also studied . data on the internal consistency , validity and reliability of the test are demonstrated in table 1 . independent sample t test was used to compare defense styles and mechanisms of patients with normal subjects ; the significance level was defined as p < 0.05 . control group included 116 individuals , 63 males and 53 females , whose ages ranged from 15 to 67 years ( mean=28 years ) . the 28 patients with pd ( 6 males and 22 females ) were between 20 to 43 years of age ( mean=33 years ) , and the 22 subjects with ocd ( 10 males and 12 females ) were between 18 to 56 ( mean=36 years ) . the experts who had been asked to correlate each item with its corresponding defense mechanism all rated 4 or 5 for each item of the persian dsq-40 as well as the original version of dsq-40 . mean of the raters agreement for each item was more than 4 , which indicated their agreement about items that represent attributed defense mechanisms satisfactorily . additionally , no conflicts were observed in the experts ' opinions about the two versions . cronbach 's alpha for all items was calculated as 0.716 ; alphas calculated separately for each item were close to each other which showed deleting specific items did not significantly improve the reliability of the test . the comparison between the defense styles in ocd and pd with normal controls noted a significant lower usage of the mature style in each group of patients when compared with the normal subjects . no significant difference was observed in the usage of the neurotic style among the groups of participants . both groups of patients with ocd and pd used the immature style significantly more than the normal controls . when defense mechanisms were studied separately and with respect to mature defenses , normal controls used sublimation and humor significantly more than patients with ocd ; this group also used humor and anticipation significantly more than patients with pd . among neurotic defenses , both groups of patients only used idealization significantly more compared to normal controls . among the immature defenses , both groups of patients had greater significant usage of projection , acting out , devaluation , autistic fantasy , splitting and rationalization than normal group . additionally , only patients with pd used passive aggression and somatization more significantly than the normal controls . data on the comparison of defense styles and defense mechanisms between patients and non - patients are shown in table 2 . the result of this study is consistent with the results of kipper 's research with regard to the field of immature defenses in patients with pd ( 16 ) ; more usage of immature style was noted in patients with pd in both studies . except for displacement in kipper 's study and rationalization in our study , other 7 immature defenses used more by patients with pd were similar in both studies . another study by kipper et al . showed a relatively similar results in the case of immature defenses in patients with pd ( 17 ) . therefore , it seems that the pathogenesis of pd is related to the immature defenses to a considerable extent ; for instance , the linkage between somatization and somatic symptoms in pd is obvious . de masi noted a nameless dread that stems from patient 's imagination in the psychodynamic of panic attacks ( 18 ) . the dread that results from one 's imagination . something to do with the immature defense of fantasy . other significantly used immature defenses can also be tracked in pathogenesis of pd when studying this disorder pathologically and pychodynamically . there are fewer studies about the relationship between defense mechanisms and obsessive - compulsive disorder compared to pd . ( 5 ) observed significantly more usage of immature style in ocd patients . in another study performed by pollock and andrews ( 14 ) it was found that two immature defenses , acting out and projection , were used more by ocd patients compared to normal controls . in our study it was found that in addition to these two immature defenses , devaluation , autistic fantasy , splitting and rationalization are also used more by patients with ocd . the question comes as why our study did not note any difference in neurotic style between patients and control subjects , whereas this difference was reported in similar studies ( 16 , 19 ) . to answer this question for example , when comparing the mean scores of neurotic defenses of the control groups in our study and the kipper 's study ( 16 ) , it is observed that undoing and pseudo - altruism have considerably higher mean scores in the iranian control group ( 6.1 and 6.6 , respectively ) than in the brazilian control group ( 3.2 and 4.6 , respectively ) . additionally , it should be noted that idealization was used more significantly by both groups of patients in the present study . the higher scores in the iranian sample of normal controls may show that these defenses are more accepted in the iranian community ; this fact makes it difficult to differentiate pathology from non - pathology according to the neurotic defenses in this population . usage of mature defenses by an individual is in a close correlation with ego maturity ( 6 ) . by accepting this fact , it is concluded that the more an individual uses the mature style ( compared to other styles ) against different stressors , the less probability exists for him / her to be caught up in a psychopathological state . spinhoven and kooiman reported that patients with anxiety disorders used mature style less than normal controls ( 19 ) . the same result was reported by andrews et al . about patients suffering from ocd and social phobia ( 5 ) . in this study , also normal controls used mature style significantly more than the two groups of patients . different results are noted in different studies with regard to mature defenses ( 14 , 16 ) . in our study , less usage of sublimation by ocd patients , less usage of anticipation by panic patients , and less usage of humor by both groups of patients were noted when compared to the control group . the differences in these studies may be due to different patterns and defenses accepted by different communities . therefore , it may be necessary to accomplish studies that are able to extract these community - dependent patterns in different populations . in general , it seems that among all clusters of defense mechanisms , immature defenses play an important role in the pathogenesis of pd and ocd . those studies describing the relationship between the pathology of these disorders and the related defenses will be of great importance in this area . the statistical analysis in this study showed acceptable validity , reliability and internal consistency for the persian version of dsq-40 . in addition , this study demonstrated more usage of immature style and less usage of mature style by both groups of patients with ocd and pd when compared with the normal controls . no significant difference was found in the usage of neurotic style among the three groups . however , in general , our data seems to be considerably consistent with that of similar studies conducted on different populations ; this may help to a more improved perception of the process of pathogenesis of ocd and pd . further studies are needed to clarify the relationship between defensive patterns and vulnerability to anxiety disorders , particularly ocd and pd .
objectivethe aim of this study was to compare defense styles and mechanisms in adult patients suffering from obsessive - compulsive disorder ( ocd ) , and panic disorder ( pd ) with normal subjects in iran.methodsdefensive patterns of 22 patients with ocd , 28 patients with pd and those of 116 normal individuals ( as a control group ) were assessed using the farsi version of defense style questionnaire-40 ( dsq-40 ) . 
 the content validity of this questionnaire was done prior to the initiation of the present study.resultsboth groups of patients with ocd or pd used more immature and less mature styles compared to the control group . 
 no significant difference was observed in the use of neurotic style between the two groups.conclusionit is suggested that immature defenses may have an important role in the pathogenesis of ocd and pd .