The main thesis of this presentation is the contention that in the clinical assessment of a depressed patient one must use not only the relatively coarse criteria of changes of mood and affect, psychomotor retardation, diurnal variation, sleep disturbance, etc. but also the finer criteria centering around his object relationships (2). These latter can be seen in the doctor/patient relationship even in the first interview. A most crucial criterion revolves around how, and to what extent, the patient reaches out towards, or withdraws from, the doctor. The use of these criteria clarifies the indications and contraindications for psychoanalysis, psychotherapy, drugs or E.C.T. in the depressed patient.
