Hamilton rating scale for depression (HAM-D)

The HAM-D is a scale frequently used in research for depression but also used clinically in day-to-day practice by psychiatrists, to quantify how bad depression is.

The template below will calculate the final score, based on the answers.

To use the template, create a new phrase and copy and paste the text below or  download and import it as PhraseExpander glossary.

{#inputForm -[title=HAMD][hideSectionVisibility=1]#}# HAM-D - HAMILTON DEPRESSION RATING SCALE - 21 item:
{#input 0 - Absent.::[1 - These feeling states indicated only on questioning.]1 - These feeling states indicated only on questioning.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - These feelings states spontaneously reported verbally.]2 - These feelings states spontaneously reported verbally.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Communicates feeling states non-verbally - i.e., through facial expression, posture, voice and tendency to weep.]3 - Communicates feeling states non-verbally - i.e., through facial expression, posture, voice and tendency to weep.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Patient reports VIRTUALLY ONLY these feeling states in his spontaneous verbal and non-verbal communication.]4 - Patient reports VIRTUALLY ONLY these feeling states in his spontaneous verbal and non-verbal communication.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Depression][display=list][prepend=1. Depression: ]#}
{#input 0 - Absent::[1 - Self-reproach, feels he has let people down.]1 - Self-reproach, feels he has let people down.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Ideas of guilt or rumination over past errors or sinful deeds.]2 - Ideas of guilt or rumination over past errors or sinful deeds.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Present illness is a punishment. Delusions of guilt.]3 - Present illness is a punishment. Delusions of guilt.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations.]4 - Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Feelings of Guilt][display=list][prepend=2. Feelings of guilt: ]#}
{#input 0 - Absent::[1 - Feels life is not worth living.]1 - Feels life is not worth living.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - ishes he were dead or any thoughts of possible death to self.]2 - ishes he were dead or any thoughts of possible death to self.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Suicide ideas or gesture.]3 - Suicide ideas or gesture.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Attempts at suicide (any serious attempt rates).]4 - Attempts at suicide (any serious attempt rates).{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Suicide][prepend=3. Suicide: ][display=list]#}
{#input 0 - No difficulty falling asleep.::[1 - Complaints of occasional difficulty falling asleep - i.e., more than 1/2 hour.]1 - Complaints of occasional difficulty falling asleep - i.e., more than 1/2 hour.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Complains of nightly difficulty falling asleep.]2 - Complains of nightly difficulty falling asleep.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[desc=Insomnia - Early][prepend=4. Insomnia (Early): ][display=list]#}
{#input 0 - No difficulty.::[1 - Patient complains of being restless and disturbed during the night.]1 - Patient complains of being restless and disturbed during the night.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Waking during the night - may getting out of bed rates 2 (except for purpose of voiding).]2 - Waking during the night - may getting out of bed rates 2 (except for purpose of voiding).{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[desc=Insomnia - Middle][prepend=5. Insomnia (Middle): ][display=list]#}
{#input 0 - No difficulty.::[1 - Waking in early hours of the morning but goes back to sleep.]1 - Waking in early hours of the morning but goes back to sleep.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Unable to fall asleep again if he gets out of bed.]2 - Unable to fall asleep again if he gets out of bed.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[desc=Insomnia - Late][prepend=6. Insomnia (Late): ][display=list]#}
{#input 0 - No difficulty.::[1 - Thoughts and feelings of incapacity, fatigue or weakness related to activities; work or hobbies.]1 - Thoughts and feelings of incapacity, fatigue or weakness related to activities; work or hobbies.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - 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 or activities).]2 - 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 or activities).{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Decrease in actual time spent in activities or decrease in productivity. In hospital, rate 3 if patient does not spend at least three hours a day in activities (hospital job or hobbies) exclusive of word chores.]3 - Decrease in actual time spent in activities or decrease in productivity. In hospital, rate 3 if patient does not spend at least three hours a day in activities (hospital job or hobbies) exclusive of word chores.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Stopped working because of present illness. In hospital, rate 4 if patient engages in no activities except ward chores, or if patient fails to perform ward chores unassisted.]4 - Stopped working because of present illness. In hospital, rate 4 if patient engages in no activities except ward chores, or if patient fails to perform ward chores unassisted.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Working Activities][prepend=7: Working Activities: ][display=list]#}
{#input 0 - Normal speech and thought.::[1 - Slight retardation at interview.]1 - Slight retardation at interview.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Obvious retardation at interview.]2 - Obvious retardation at interview.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Interview difficult.]3 - Interview difficult.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Complete stupor.]4 - Complete stupor.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Retardation (Slowness of thought and speech; impaired ability to concentrate; decreased motor activity)][prepend=8. Retardation (Slowness of thought and speech; impaired ability to concentrate; decreased motor activity): ][display=list]#}
{#input 0 - None.::[1 - Fidgetiness.]1 - Fidgetiness.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Playing with hands, hair, etc.]2 - Playing with hands, hair, etc.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Moving about, can't sit still.]3 - Moving about, can't sit still.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Hand wringing, nail biting, hair-pulling, biting of lips.]4 - Hand wringing, nail biting, hair-pulling, biting of lips.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Agitation][prepend=9. Agitation: ][display=list]#}
{#input 0 - No difficulty.::[1 - Subjective tension and irritability.]1 - Subjective tension and irritability.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Worrying about minor matters.]2 - Worrying about minor matters.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Apprehensive attitude apparent in face or speech.]3 - Apprehensive attitude apparent in face or speech.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Fears expressed without questioning.]4 - Fears expressed without questioning.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Anxiety (Psychic)][prepend=10. Anxiety (Psychic): ][display=list]#}
{#input 0 - Absent.::[1 - Mild.]1 - Mild.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Moderate.]2 - Moderate.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Severe.]3 - Severe.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Incapacitating.]4 - Incapacitating.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[desc=Anxiety (Somatic)][prepend=11. Anxiety (Somatic): ][display=list]#}
{#input 0 - None.::[1 - Loss of appetite but eating without staff encouragement. Heave feelings in abdomen.]1 - Loss of appetite but eating without staff encouragement. Heave feelings in abdomen.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Difficulty feeding without staff urging. Request or requires laxatives or medication for bowels or medication for G.I. symptoms.]2 - Difficulty feeding without staff urging. Request or requires laxatives or medication for bowels or medication for G.I. symptoms.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[desc=Somatic Symptoms (Gastrointestinal)][prepend=12. Somatic Symptoms (Gastrointestinal): ][display=list]#}
{#input 0 - None.::[1 - Heaviness in limbs, back or head. Backaches, headaches, muscle aches. Loss of energy and fatigability.]1 - Heaviness in limbs, back or head. Backaches, headaches, muscle aches. Loss of energy and fatigability.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Any clear-cut symptoms rates 2.]2 - Any clear-cut symptoms rates 2.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[desc=Somatic Symptoms (General)][prepend=13. Somatic Symptoms (General): ][display=list]#}
{#input 0 - Absent::[1 - Mild.]1 - Mild.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Severe.]2 - Severe.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[prepend=14. Genital Symptoms (Symptoms such as loss of libido, menstrual disturbances): ][display=list][desc=Genital Symptoms (Symptoms such as loss of libido, menstrual disturbances)]#}
{#input 0 - Not present::[1 - Self-absorption (bodily).]1 - Self-absorption (bodily).{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Preoccupation with health.]2 - Preoccupation with health.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Frequent complaints, requests for help, etc.]3 - Frequent complaints, requests for help, etc.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Hypochondriacal delusions.]4 - Hypochondriacal delusions.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[prepend=15. Hypochondriasis: ][display=list][desc=Hypochondriasis]#}
{#input 0 - No weight loss.::[1 - Probable weight loss associated with present illness.]1 - Probable weight loss associated with present illness.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Definite (according to patient) weight loss.]2 - Definite (according to patient) weight loss.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Not assessed.]3 - Not assessed.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#} -[prepend=16-A. Loss of Weight (A or B) - A by history: ][display=list][desc=Loss of Weight (A or B) - A by history]#}
{#input 0 - Less than 1 lb. weight loss in week.::[1 - Greater than 1 lb. weight loss in week.]1 - Greater than 1 lb. weight loss in week.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Greater than 2 lb. weight loss in week.]2 - Greater than 2 lb. weight loss in week.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Not assessed.]3 - Not assessed.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#} -[prepend=16-B. Loss of Weight (A or B) - B On weekly ratings by ward psychiatrist, when actual weight changes are measured: ][display=list][desc=Loss of Weight (A or B) - B On weekly ratings by ward psychiatrist, when actual weight changes are measured]#}
{#input 0 - Acknowledges being depressed and ill.::[1 - Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc.]1 - Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Denies being ill at all.]2 - Denies being ill at all.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[prepend=17. Insight: ][display=list][desc=Insight]#}
{#input 0 - No variation.::[1 - Worse in A.M, Mild Variation.]1 - Worse in A.M, Mild Variation.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Worse in P.M, Mild Variation.]2 - Worse in P.M, Mild Variation.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[1 - Mild]1 - Mild{#varSet -[counter=1][start=3][name=Total][hide=1][inc=1]#}::[2 - Severe]2 - Severe{#varSet -[counter=1][start=4][name=Total][hide=1][inc=2]#} -[prepend=18. Diurnal Variation: ][display=list][desc=Diurnal Variation (When present, mark the severity of the variation. Enter "O", if NO variation)][separator=, ][multi=1]#}
{#input 0 - Absent::[1 - Mild.]1 - Mild.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Moderate.]2 - Moderate.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Severe.]3 - Severe.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#}::[4 - Incapacitating.]4 - Incapacitating.{#varSet -[counter=1][start=4][name=Total][hide=1][inc=4]#} -[prepend=19. Depersonalization and Derealization (Such as: Feelings of unreality, nihilistic ideas): ][display=list][desc=Depersonalization and Derealization (Such as: Feelings of unreality, nihilistic ideas)]#}
{#input 0 - None.::[1 - Suspicious.]1 - Suspicious.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Ideas of reference.]2 - Ideas of reference.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#}::[3 - Delusions of reference and persecution.]3 - Delusions of reference and persecution.{#varSet -[counter=1][start=3][name=Total][hide=1][inc=3]#} -[prepend=20. Paranoid Symptoms (Not with a depressive quality): ][display=list][desc=Paranoid Symptoms (Not with a depressive quality)]#}
{#input 0 - Absent::[1 - Mild.]1 - Mild.{#varSet -[counter=1][start=1][name=Total][hide=1]#}::[2 - Severe.]2 - Severe.{#varSet -[counter=1][start=2][name=Total][hide=1][inc=2]#} -[prepend=21. Obsessional and Compulsive Symptoms: ][display=list][desc=Obsessional and Compulsive Symptoms]#}

== Score: {#var Total#} (0 - 7 = Normal; 8 - 13 = Mild Depression; 14-18 = Moderate Depression; 19 - 22 = Severe Depression; 23 or higher = Very Severe Depression).

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Courtesy of Dr. Niels Nielsen

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