Hamilton Depression Rating Scale -- NeurologyToolKit
The Hamilton Depression Rating Scale (HAM-D or HDRS) was originally published in 1960 in the Journal of neurology, neurosurgery, and psychiatry. The HDRS is a widely used tool to evaluate for signs of depression. The HDRS is calculated as the sum of the point values of each question. Although the original HDRS included 21 questions, only 17 of these questions are scored. The maximum HDRS scores is 52 (indicating the most severe depression), whereas a score of 0 indicates an absence of signs of depression. The following classification for HDRS score severity has been proposed:0–7: normal8–16: mild depression17–23: moderate depression24: severe depression
Original Literature:Hamilton, Max. "A rating scale for depression." Journal of neurology, neurosurgery, and psychiatry 23.1 (1960): 56.Validation Literature:Hamilton, M. A. X. "Development of a rating scale for primary depressive illness." British journal of social and clinical psychology 6.4 (1967): 278-296. Aben, Ivo, et al. "Validity of the beck depression inventory, hospital anxiety and depression scale, SCL-90, and hamilton depression rating scale as screening instruments for depression in stroke patients." Psychosomatics 43.5 (2002): 386-393.Additional Literature:Zimmerman, Mark, et al. "Severity classification on the Hamilton depression rating scale." Journal of affective disorders 150.2 (2013): 384-388. Williams, Janet BW. "A structured interview guide for the Hamilton Depression Rating Scale." Archives of general psychiatry 45.8 (1988): 742-747.
The HDRS was created by Dr. Max Hamilton, MD. Dr. Hamilton was Nuffield Professor of Psychiatry at the University of Leeds prior to his death in 1988. His research focused on the application of quantitative measures to psychiatric disease.To view his publications, please visit PubMed.
Hamilton Depression Rating Scale Score: 0 / 52 = 0.0 %Graphical Hamilton Depression Rating Scale Score: (%)
PLEASE COMPLETE THE SCALE BASED ON A STRUCTURED INTERVIEW
Instructions: for each item select the one “cue” which best characterizes the patient. Be sure to record the answers in the appropriate spaces (positions 0 through 4).
1. DEPRESSED MOOD (sadness, hopeless, helpless, worthless)
1. DEPRESSED MOOD (sadness, hopeless, helpless, worthless)
2. FEELINGS OF GUILT
2. FEELINGS OF GUILT
3. SUICIDE
3. SUICIDE
4. INSOMNIA: EARLY IN THE NIGHT
4. INSOMNIA: EARLY IN THE NIGHT
5. INSOMNIA: MIDDLE OF THE NIGHT
5. INSOMNIA: MIDDLE OF THE NIGHT
6. INSOMNIA: EARLY HOURS OF THE MORNING
6. INSOMNIA: EARLY HOURS OF THE MORNING
7. WORK AND ACTIVITIES
7. WORK AND ACTIVITIES
8. RETARDATION (slowness of thought and speech, impaired ability to concentrate, decreased motor activity)
8. RETARDATION (slowness of thought and speech, impaired ability to concentrate, decreased motor activity)
9. AGITATION
9. AGITATION
10. ANXIETY PSYCHIC
10. ANXIETY PSYCHIC
11. ANXIETY SOMATIC (physiological concomitants of anxiety) such as: gastro-intestinal – dry mouth, wind, indigestion, diarrhea, cramps, belching; cardio-vascular – palpitations, headaches; respiratory – hyperventilation, sighing; urinary frequency; sweating
11. ANXIETY SOMATIC (physiological concomitants of anxiety) such as: gastro-intestinal – dry mouth, wind, indigestion, diarrhea, cramps, belching; cardio-vascular – palpitations, headaches; respiratory – hyperventilation, sighing; urinary frequency; sweating
12. SOMATIC SYMPTOMS GASTRO-INTESTINAL
12. SOMATIC SYMPTOMS GASTRO-INTESTINAL
13. GENERAL SOMATIC SYMPTOMS
13. GENERAL SOMATIC SYMPTOMS
14. GENITAL SYMPTOMS (symptoms such as loss of libido, menstrual disturbances)
14. GENITAL SYMPTOMS (symptoms such as loss of libido, menstrual disturbances)
11. HYPOCHONDRIASIS
11. HYPOCHONDRIASIS
16. LOSS OF WEIGHT (RATE EITHER a OR b) -- a) According to the patient: b) According to weekly measurements:
16. LOSS OF WEIGHT (RATE EITHER a OR b) -- a) According to the patient: b) According to weekly measurements:
17. INSIGHT
17. INSIGHT
Hamilton Depression Rating Scale Score: 0 / 52 = 0.0 %
Graphical Hamilton Depression Rating Scale Score: (%)Pertinent Positives:
Pertinent Negatives:
Depressed mood absent; Feelings of guilt absent; Suicidal thoughts absent; No difficulty falling asleep; No difficulty sleeping (middle of the night); No difficulty sleeping (early hours of morning); No difficulty with work and activities; Normal speech and thoughy; No agitation; No difficulty with psychic anxiety; Absent physiological/somatic signs of anxiety; No gastro-intestinal somatic symptoms; No general somatic symptoms; Absent genital symptoms; Not present; No weight loss / Less than 1 lb weight loss in week; Acknowledges being depressed and ill;