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The Hamilton Depression Rating Scale is a 17-item scale that evaluates depressed mood, vegetative and cognitive symptoms of depression, and comorbid anxiety symptoms. It provides ratings on current DSM-IV symptoms of depression, with the exceptions of hypersomnia, increased appetite, and concentration/indecision. The instrument is loaded heavily for melancholic depression, psychotic depression, and hypochondriasis. The HAM-D was designed to be used to assess severity of depression and to track change in depressive symptoms over time in treatment. The instrument has been found to be more sensitive to treatment change measure (both drug and psychotherapy) than several self-rated scales.

The HAM-D is the standard depression outcome measure used in clinical trials presented to the Food and Drug Administration by pharmaceutical companies for approval of New Drug Applications. It is also the primary outcome measure in the National Institute of Mental Health collaborative studies comparing pharmacotherapy with psychotherapy for the treatment of depression. The HAMD is the usual standard against which other depression rating scales are validated. The scale has been translated into many European and Asian languages.

Benefits of HAM-D:

• Widely-used – The HAM-D is the most widely used instrument for clinical assessment of depressive symptoms.
• Well-validated – The tool was developed in 1960 and has since that time has been widely evaluated and established as a highly reliable and valid assessment tool for the assessment of depressive severity.
• ‘Gold’-standard of depression rating scales.
• Frequently used in studies as an anchor with which to compare newer instruments.

Guidelines For Clinical Interpretation

The higher the score the more severe the depression. A score of 11 is generally regarded as indicative of a diagnosis of depression. A score of 10-13 = mild depression; a score of 14-17 = moderate depression; a score >17 = moderate to severe depression.