17-item clinician-rated scale for grading the severity of depression.
Rate each item from a clinical interview, choosing the description that best fits the patient over the past week.
Sadness, hopelessness, helplessness, worthlessness.
Early in the night.
Middle of the night.
Early hours of the morning.
Slowness of thought, speech and movement.
Physiological accompaniments of anxiety.
Loss of libido, menstrual disturbance.
Rate each item from a clinical interview, choosing the description that best fits the patient over the past week.
Sadness, hopelessness, helplessness, worthlessness.
Early in the night.
Middle of the night.
Early hours of the morning.
Slowness of thought, speech and movement.
Physiological accompaniments of anxiety.
Loss of libido, menstrual disturbance.
02 - The clinician's brief
01 - What it measures
The HAM-D grades the severity of a depressive episode in patients already diagnosed with depression. A clinician rates 17 items covering mood, guilt, suicidal thoughts, insomnia, work and interest, psychomotor change, anxiety, somatic and genital symptoms, hypochondriasis, weight loss and insight, based on a clinical interview about the past week. It is an observer-rated severity measure, not a self-report screener.
02 - Origin & purpose
Max Hamilton published the scale in 1960 and revised it in 1967. It is in the public domain and remains one of the most widely used outcome measures in depression research and antidepressant trials. The plain version scores the first 17 items; later items such as diurnal variation and depersonalisation are descriptive and are not added to the severity total. Structured interview guides such as the SIGH-D and GRID-HAMD carry separate copyright and are not reproduced here.
03 - Scoring & cutoffs
Nine items are rated 0 to 4 and eight items 0 to 2, giving a total of 0 to 52. Common severity bands are 0 to 7 (no depression), 8 to 13 (mild), 14 to 18 (moderate), 19 to 22 (severe) and 23 or above (very severe). A reduction of 50 percent or more is often used to define treatment response and a score of 7 or below to define remission.
04 - When to use it
Use it to grade severity and track change over time in patients with an established diagnosis, for example before and after starting treatment. It is clinician-rated from an interview, so it is not suitable as a patient send-out. For self-report screening, the PHQ-9 is a better fit.
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