An ethological analysis of depression: comparison between ethological recording and Hamilton rating of five endogenously depressed patients.

Five patients who had all been diagnosed as endogenously depressed at admission were rated twice a week and observed ethologically for 4 h/week during the entire hospitalization (4-11 weeks). Observations were carried out in the actual social environment of the ward. Data were analysed based on the parameters of behaviour diversity, behaviour activity, and marker elements. Depression was scored as low values of diversity and activity; improvement corresponded to higher values of these parameters. As possible markers of improvement, 8 behavioural elements have been singled out. One patient constituted a special case: at discharge she was rated as completely recovered; however, the ethological data indicated a serious aggravation. The day after discharge the patient attempted to commit suicide. It is concluded that ethological psychiatric research may be able to supplement traditional psychiatry with decisive information in the areas of diagnosis and treatment assessment.