Coping strategies and defense mechanisms and their relevance for the recovery after discectomy.

Although several empirical studies have shown that psychological and social characteristics predict recovery after lumbar discectomy, the possible significance of the psychodynamic concept of defense mechanisms has been neglected. To investigate the predictive usefulness of defense mechanisms, coping strategies, and depression, 52 consecutive admissions were assessed before their operations and again six months later (n = 48). Using three outcome criteria, 8 patients (16, 7%) were classified as having poor operation outcomes. A stepwise discriminant analysis correctly classified 87.7% of these poor outcomes. The groups with poor and good outcome differed significantly in the prominence of two defense mechanisms: "rationalization" and "regression".