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Hamilton depression scale (HAM-D scale)

Calculator

When to use

Depressed mood

Absent

Sadness

Occasional weeping

Frequent weeping

Extreme symptoms

Feelings of guilt

Absent

Self-reproach, feels he/she has let people down

Ideas of guilt

Present illness is a punishment, delusions of guilt

Hallucinations of guilt

Suicide

Absent

Feels life is not worth living

Wishes he/she were dead

Suicidal ideas or gestures

Attempts at suicide

Initial insomnia (difficulty falling asleep)

Absent

Occasional

Frequent

Insomnia during the night (restless and disturbed during the night)

Absent

Occasional

Frequent

Delayed insomnia (waking in early hours of the morning and unable to fall asleep again)

Absent

Occasional

Frequent

Work and interests

No difficulty

Feelings of incapacity, listlessness, indecision, and vacillation

Loss of interest in hobbies, decreased social activities

Productivity decreased

Unable to work, stopped working because of present illness only if absent from work after treatment or recovery may rate a lower score)

Retardation (slowness of thought, speech, and activity, apathy, stupor)

Absent

Slight retardation at interview

Obvious retardation at interview

Interview difficult

Complete stupor

Agitation (restlessness associated with anxiety)

Absent

Mild

Severe

Psychiatric anxiety

Absent

Tension and irritability

Worrying about minor matters

Apprehensive attitude

Fears

Somatic anxiety (gastrointestinal, cardiovascular, respiratory, genitourinary, etc.)

Absent

Mild

Moderate

Severe

Incapacitating

Gastrointestinal somatic symptoms (loss of appetite, heavy feeling in abdomen, constipation)

Absent

Mild

Severe

General somatic symptoms (heaviness in limbs, back, or head, diffuse backache, loss of energy and fatigability)

Absent

Mild

Severe

Genital symptoms (loss of libido, menstrual disturbances)

Absent

Mild

Severe

Hypochondriasis

Not present

Bodily self-absorption

Preoccupation with health

Querulous attitude

Hypochondriacal delusions

Weight loss

Absent

Slight

Obvious

Insight (must be interpreted in terms of patient's understanding and background)

No loss

Partial or doubtful loss

Loss of insight

Calculation

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The Hamilton Depression Scale, also known as the HAM-D scale, is a clinical calculator used to quantify the severity of depressive symptoms in patients diagnosed with depression. It is widely used in both clinical and research settings. The HAM-D scale assesses a variety of symptoms associated with depression such as mood, feelings of guilt, suicide ideation, insomnia, agitation or retardation, anxiety, weight loss, and somatic symptoms. The scale is typically used in adult populations, but can also be used in adolescents with modifications. The clinical utility of the HAM-D scale is to monitor the severity of depression and response to treatment in patients diagnosed with depressive disorder. It is not designed to diagnose depression, but rather to measure the severity of depressive symptoms in individuals already diagnosed with the condition. The HAM-D scale should not be used as a diagnostic tool for depression, and it may not be suitable for use in patients with cognitive impairment or severe communication difficulties due to the nature of the questions asked. It also may not capture all aspects of depression, such as atypical symptoms or depression with comorbid anxiety.

Reference

Danilo Carrozzino, Chiara Patierno, Giovanni A Fava et al. The Hamilton Rating Scales for Depression: A Critical Review of Clinimetric Properties of Different Versions. Psychother Psychosom. 2020;89(3):133-150.

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