Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Hamilton Depression Rating Scale (HAM-D)

    Stratifies severity of depression, similar to PHQ-9.
    Favorite

    INSTRUCTIONS

    The original HAM-D has 21 items, but scoring is based only on the first 17.

    When to Use

    Do you use the Hamilton Depression Rating Scale and want to contribute your expertise? Join our contributor team!

    Absent
    0
    Sadness
    +1
    Occasional weeping
    +2
    Frequent weeping
    +3
    Extreme symptoms
    +4
    Absent
    0
    Self-reproach, feels he/she has let people down
    +1
    Ideas of guilt
    +2
    Present illness is a punishment, delusions of guilt
    +3
    Hallucinations of guilt
    +4
    Absent
    0
    Feels life is not worth living
    +1
    Wishes he/she were dead
    +2
    Suicidal ideas or gestures
    +3
    Attempts at suicide
    +4
    Absent
    0
    Occasional
    +1
    Frequent
    +2
    Absent
    0
    Occasional
    +1
    Frequent
    +2
    Absent
    0
    Occasional
    +2
    Frequent
    +2
    No difficulty
    0
    Feelings of incapacity, listlessness, indecision, and vacillation
    +1
    Loss of interest in hobbies, decreased social activities
    +2
    Productivity decreased
    +3
    Unable to work, stopped working because of present illness only (if absent from work after treatment or recovery may rate a lower score)
    +4
    Absent
    0
    Slight retardation at interview
    +1
    Obvious retardation at interview
    +2
    Interview difficult
    +3
    Complete stupor
    +4
    Absent
    0
    Mild
    +1
    Severe
    +2
    Absent
    0
    Tension and irritability
    +1
    Worrying about minor matters
    +2
    Apprehensive attitude
    +3
    Fears
    +4
    Absent
    0
    Mild
    +1
    Moderate
    +2
    Severe
    +3
    Incapacitating
    +4
    Absent
    0
    Mild
    +1
    Severe
    +2
    Absent
    0
    Mild
    +1
    Severe
    +2
    Absent
    0
    Mild
    +1
    Severe
    +2
    Not present
    0
    Bodily self-absorption
    +1
    Preoccupation with health
    +2
    Querulous attitude
    +3
    Hypochondriacal delusions
    +4
    None
    0
    Slight
    +1
    Obvious or severe
    +2
    No loss
    0
    Partial or doubtful loss
    +1
    Loss of insight
    +2

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    Do you use the Hamilton Depression Rating Scale and want to contribute your expertise? Join our contributor team!

    Formula

    Addition of the selected points:

    Variable

    Points

    Depressed mood (gloomy attitude, pessimism about the future, feeling of sadness, tendency to weep)

    Absent

    0

    Sadness

    1

    Occasional weeping

    2

    Frequent weeping

    3

    Extreme symptoms

    4

    Feelings of guilt

    Absent

    0

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

    1

    Ideas of guilt

    2

    Present illness is a punishment; delusions of guilt

    3

    Hallucinations of guilt

    4

    Suicide

    Absent

    0

    Feels life is not worth living

    1

    Wishes he/she were dead

    2

    Suicidal ideas or gestures

    3

    Attempts at suicide

    4

    Initial insomnia (difficulty falling asleep)

    Absent

    0

    Occasional

    1

    Frequent

    2

    Insomnia during the night (restless, disturbed, waking at night)

    Absent

    0

    Occasional

    1

    Frequent

    2

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

    Absent

    0

    Occasional

    1

    Frequent

    2

    Work and interests

    No difficulty

    0

    Feelings of incapacity, listlessness, indecision and vacillation

    1

    Loss of interest in hobbies, decreased social activities

    2

    Productivity decreased

    3

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

    4

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

    Absent

    0

    Slight retardation at interview

    1

    Obvious retardation at interview

    2

    Interview difficult

    3

    Complete stupor

    4

    Agitation (restlessness associated with anxiety)

    Absent

    0

    Mild

    1

    Severe

    2

    Psychiatric anxiety

    Absent

    0

    Tension and irritability

    1

    Worrying about minor matters

    2

    Apprehensive attitude

    3

    Fears

    4

    Somatic anxiety (gastrointestinal, indigestion, cardiovascular, palpitations, headaches, respiratory, genitourinary, etc.)  

    Absent

    0

    Mild

    1

    Moderate

    2

    Severe

    3

    Incapacitating

    4

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

    Absent

    0

    Mild

    1

    Severe

    2

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

    Absent

    0

    Mild

    1

    Severe

    2

    Genital symptoms (loss of libido, menstrual disturbances)

    Absent

    0

    Mild

    1

    Severe

    2

    Hypochondriasis

    Not present

    0

    Bodily self-absorption

    1

    Preoccupation with health

    2

    Querulous attitude

    3

    Hypochondriacal delusions

    4

    Weight loss

    None

    0

    Slight

    1

    Obvious or severe

    2

    Insight (interpret in context of patient’s understanding and background)

    No loss

    0

    Partial or doubtful loss

    1

    Loss of insight

    2

    Facts & Figures

    Interpretation: 

    HAM-D Score

    Grade

    0-7

    Normal

    8-13

    Mild depression

    14-18

    Moderate depression

    19-22

    Severe depression

    ≥23

    Very severe depression

    Dr. Max Hamilton

    About the Creator

    Max Hamilton, MD, FRCP, (d. 1988) was a senior lecturer in psychiatry at the University of Leeds in England. He was also president of the British Psychological Society and received the Paul Hoch Prize for Distinguished Psychiatric Research from the American Psychopathological Association in 1980. Dr. Hamilton’s research focused primarily on psychometrics and clinical statistics.

    To view Dr. Max Hamilton's publications, visit PubMed

    About the Creator
    Dr. Max Hamilton