The Ego Impairment Index as a Predictor of Outcome in Melancholic Depressed Patients Treated With Tricyclic Antidepressants

Abstract

The standard model of assessing ego impairment relies on patients' accurate self-report and description of their behavior. This study offers an alternative approach to assessing ego impairment in a population of major depression, melancholic type outpatients treated with tricyclic antidepressants. A new index called the Ego Impairment Index (ElI) was developed. The index is derived from the Rorschach test and offers a single composite score of ego impairment. It was hypothesized that those melancholic, biologically depressed individuals who were lacking in ego resources were less likely to benefit from tricyclic antidepressant treatment. Thus, the EII could predict overall outcome while on antidepressants. The results support that the level of ego impairment, as assessed by the EII, could predict depression outcome averaged over 9 weeks of tricyclic antidepressant treatment.