01 - Scoring & cutoffs
Anxiety · 14 items · 0–56 · Hamilton 1959
HAM-A: Scoring, Cutoffs & Interpretation
14-item clinician-rated scale measuring the severity of anxiety symptoms.
Rate the severity of each symptom the patient has experienced over the past week, from 0 (not present) to 4 (very severe).
Not present0
Mild1
Moderate2
Severe3
Very severe4
Score
01Anxious mood: worries, anticipation of the worst, fearful anticipation, irritability.
-
02Tension: feelings of tension, fatigability, startle response, moved to tears easily, trembling, restlessness, inability to relax.
-
03Fears: of dark, of strangers, of being left alone, of animals, of traffic, of crowds.
-
04Insomnia: difficulty falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.
-
05Intellectual (cognitive): difficulty in concentration, poor memory.
-
06Depressed mood: loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.
-
07Somatic (muscular): pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
-
08Somatic (sensory): tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.
-
09Cardiovascular symptoms: tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.
-
10Respiratory symptoms: pressure or constriction in chest, choking feelings, sighing, dyspnoea.
-
11Gastrointestinal symptoms: difficulty in swallowing, wind, abdominal pain, burning sensations, fullness, nausea, vomiting, looseness of bowels, weight loss, constipation.
-
12Genitourinary symptoms: frequency of micturition, urgency of micturition, amenorrhoea, menorrhagia, loss of libido, premature ejaculation, impotence.
-
13Autonomic symptoms: dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.
-
14Behaviour at interview: fidgeting, restlessness, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing.
-
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Rate the severity of each symptom the patient has experienced over the past week, from 0 (not present) to 4 (very severe).
Scored locally - nothing leaves this page
01Anxious mood: worries, anticipation of the worst, fearful anticipation, irritability.
02Tension: feelings of tension, fatigability, startle response, moved to tears easily, trembling, restlessness, inability to relax.
03Fears: of dark, of strangers, of being left alone, of animals, of traffic, of crowds.
04Insomnia: difficulty falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.
05Intellectual (cognitive): difficulty in concentration, poor memory.
06Depressed mood: loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.
07Somatic (muscular): pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
08Somatic (sensory): tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.
09Cardiovascular symptoms: tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.
10Respiratory symptoms: pressure or constriction in chest, choking feelings, sighing, dyspnoea.
11Gastrointestinal symptoms: difficulty in swallowing, wind, abdominal pain, burning sensations, fullness, nausea, vomiting, looseness of bowels, weight loss, constipation.
12Genitourinary symptoms: frequency of micturition, urgency of micturition, amenorrhoea, menorrhagia, loss of libido, premature ejaculation, impotence.
13Autonomic symptoms: dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.
14Behaviour at interview: fidgeting, restlessness, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing.
0 of 140 / 56
02 - The clinician's brief
Score
Severity
Interpretation
0–17
Mild anxiety
Mild anxiety severity.
18–24
Mild to moderate
Mild to moderate anxiety severity.
25–30
Moderate to severe
Moderate to severe anxiety severity.
31–56
Severe anxiety
Severe anxiety severity. Active treatment is usually warranted.
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