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Hamilton Depression Rating Scale (HDRS)
The Hamilton Depression Rating Scale (HDRS) is a 29-item clinician-rated scale that is used to measure the severity of depression. It was developed by Max Hamilton in 1960 and is one of the most widely used measures of depression.
The HDRS assesses the following symptoms of depression:
- Somatic (physical) symptoms, such as loss of appetite, weight loss, fatigue, and sleep disturbance
- Affective (mood) symptoms, such as sadness, hopelessness, and worthlessness
- Cognitive (thinking) symptoms, such as difficulty concentrating, indecisiveness, and suicidal thoughts
- Behavioral symptoms, such as social withdrawal, loss of interest in activities, and psychomotor agitation or retardation
The HDRS is scored by summing the item scores. The total score can range from 0 to 54, with higher scores indicating a greater severity of depression.
The HDRS has been shown to be a reliable and valid measure of depression. It has good internal consistency, test-retest reliability, and discriminant validity.
The HDRS is used in a variety of settings, including clinical trials, research studies, and clinical practice. It can be used to diagnose depression, assess the severity of depression, monitor treatment response, and predict treatment outcome.
The HDRS has a few limitations. It is not a diagnostic tool and should not be used to diagnose depression. It is also not a comprehensive measure of depression and does not assess all symptoms of depression. Finally, it can be time-consuming to administer.
Overall, the HDRS is a useful tool for assessing the severity of depression. It is reliable and valid, and it is used in a variety of settings.
- Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery & Psychiatry, 23, 56-62.
- Guy, W. (1976). ECDEU Assessment Manual for Psychoactive Drugs. Rockville, MD: National Institute of Mental Health.
- Zimmerman, M., & Coryell, W. (1989). Diagnostic efficiency of the Hamilton Depression Rating Scale. Archives of General Psychiatry, 46, 796-804.
The HDRS is a valuable tool for assessing the severity of depression. It is reliable and valid, and it is used in a variety of settings. However, it is important to be aware of the limitations of the HDRS. It is not a diagnostic tool and should not be used to diagnose depression. It is also not a comprehensive measure of depression and does not assess all symptoms of depression. Finally, it can be time-consuming to administer.
If you are concerned that you or someone you know may be experiencing depression, it is important to seek professional help. A mental health professional can help you to assess your symptoms and develop a treatment plan.
Here are some additional information about the HDRS:
- The HDRS is a clinician-rated scale, which means that it is administered by a trained mental health professional.
- The HDRS is a self-report scale, which means that the patient completes the scale on their own.
- The HDRS is a structured interview, which means that the clinician asks the patient a series of specific questions.
- The HDRS is a semi-structured interview, which means that the clinician can ask additional questions to clarify the patient’s responses.
- The HDRS is a dimensional scale, which means that it measures the severity of depression on a continuum.
- The HDRS is a continuous scale, which means that it can be used to measure changes in the severity of depression over time.
- The HDRS is a reliable scale, which means that it produces consistent results when it is administered to the same patient on different occasions.
- The HDRS is a valid scale, which means that it measures what it is intended to measure.
- The HDRS is a sensitive scale, which means that it can detect small changes in the severity of depression.
- The HDRS is a specific scale, which means that it measures depression and not other conditions.
- The HDRS is a clinically useful scale, which means that it can be used to diagnose depression, assess the severity of depression, monitor treatment response, and predict treatment outcome.
Hamilton Depression Rating Scale (HAMD-17)
0. Absent1. These feeling states indicated only on questioning2. These feeling states spontaneously reported verbally3. Communicates feeling states non-verbally – i.e.‚ through facial expression‚ posture‚ voice‚ and tendency to weep4. Patient reports VIRTUALLY ONLY these feeling states in his spontaneous verbal and non-verbal communication
0. Absent.1. Self reproach‚ feels he has let people down2. Ideas of guilt or rumination over past errors or sinful deeds3. Present illness is a punishment. Delusions of guilt4. Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations
0. Absent1. Feels life is not worth living3. Suicidal ideas or gesture4. Attempts at suicide (any serious attempt rates 4)
0. No difficulty falling asleep1. Complains of occasional difficulty falling asleep – i.e.‚ more than 1/2 hour2. Complains of nightly difficulty falling asleep
1. Patient complains of being restless and disturbed during the night2. Waking during the night – any getting out of bed rates 2 (except for purposes of voiding)
0. No difficulty1. Waking in early hours of the morning but goes back to sleep2. Unable to fall asleep again if he gets out of bed
0. No difficulty1. Thoughts and feelings of incapacity‚ fatigue or weakness related to activities‚ work or hobbies2. Loss of interest in activity‚ hobbies or work – either directly reported by patient‚ or indirect in listlessness‚ indecision and vacillation (feels he has to push self to work oractivities)3. Decrease in actual time spent in activities or decrease in productivity4. Stopped working because of present illness
0. Normal speech and thought1. Slight retardation at interview2. Obvious retardation at interview3. Interview difficult4. Complete stupor
0. None1. Fidgetiness2. Playing with hands‚ hair‚ etc.3. Moving about‚ can’t sit still.4. Hand wringing‚ nail biting‚ hair-pulling‚ biting of lips.
0. No difficulty1. Subjective tension and irritability2. Worrying about minor matters4. Fears expressed without questioning
0. Absent1. Mild2. Moderate3. Severe4. Incapacitating
0. None.1. Loss of appetite but eating without encouragement from others. Food intake about normal2. Difficulty eating without urging from others. Marked reduction of appetite and food intake.
0. None1. Heaviness in limbs‚ back or head. Backaches‚ headache or muscle aches. Loss of energy and fatigability.2. Any clear-cut symptom rates “2”
0. Absent1. Mild2. Severe
0. Not present1. Self-absorption (bodily)2. Preoccupation with health3. Frequent complaints‚ requests for help‚ etc.4. Hypochondriacal delusions
0. No weight loss1. Probable weight loss associated with present illness2. Definite (according to patient) weight loss3. Not assessed
0. Acknowledges being depressed and ill1. Acknowledges illness but attributes cause to bad food‚ climate‚ overwork‚ virus‚ need for rest‚ etc.2. Denies being ill at all
0. None1. Mild2. Severe
0. Absent1. Mild2. Moderate3. Severe4. Incapacitating
0. None1. Suspicious2. Ideas of reference3. Delusions of reference
0. Absent1. Mild2. Severe
0. No weight gain.1. Probable weight gain due to current depression.2. Definite (according to patient) weight gain due to depression.
0. Interacts with other people as usual.1. Less interested in socializing with others but continues to do so.2. Interacting less with other people in social (optional) situations.3. Interacting less with other people in work or family situations (i.e. where this is necessary).4. Marked withdrawal from others in family or work situations.
0. No increase in appetite.1. Wants to eat a little more than usual.2. Wants to eat somewhat more than normal.3. Wants to eat much more than usual.
0. Is not eating more than usual.1. Is eating a little more than usual.2. Is eating somewhat more than usual.3. Is eating much more than normal.
0. No change in food preference or consumption.1. Craving or eating more carbohydrates (starches or sugars) than before.2. Craving or eating much more carbohydrates than before.3. Irresistible craving or eating of sweets or starches.
0. No increase in sleep length.1. At least 1 hour increase in sleep length.2. 2+ hour increase.3. 3+ hour increase.4. 4+ hour increase.
0. Does not feel more fatigued than usual.1. Feels more fatigued than usual but this has not impaired function significantly; less frequent than in (2).2. More fatigued than usual; at least one hour a day; at least three days a week.3. Fatigued much of the time most days.4. Fatigued almost all the time.
Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62
Williams JB: A structured interview guide for the Hamilton depression rating scale. Arch GenPsychiatry 1988; 45:742–7
Muller MJ‚ Dragicevic A: Standardized rater training for the Hamilton Depression Rating Scale (HAMD-17) in psychiatric novices. J Affective Dis 2003; 77:65–9
Hamilton M: Hamilton rating scale for Depression (Ham-D)‚ in Handbook of psychiatric measures. Washington DC‚ APA‚ 2000‚ pp 526–8
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