Hamilton Depression Rating Scale (HAM-D)

1. Depressed Mood Sadness, hopeless, helpless, worthless feelings.

Absent.(0) These feeling states indicated only on questioning.(1) These feeling states spontaneously reported verbally.(2) Communicates feeling states non-verbally (e.g., facial expression, posture, voice, weeping).(3) Patient reports virtually only these feeling states in spontaneous verbal and non-verbal communication.(4)

2. Feelings of Guilt Self-reproach, belief of having let others down, ideas of guilt, delusions.

Absent.(0) Self reproach, feels he/she has let people down.(1) Ideas of guilt or rumination over past errors or sinful deeds.(2) Present illness is a punishment. Delusions of guilt.(3) Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations.(4)

3. Suicide Thoughts of death, suicidal ideas, gestures, or attempts.

Absent.(0) Feels life is not worth living.(1) Wishes he/she were dead or any thoughts of possible death to self.(2) Ideas or gestures of suicide.(3) Attempts at suicide (any serious attempt rate 4).(4)

4. Insomnia: Early in the Night Difficulty falling asleep.

No difficulty falling asleep.(0) Complains of occasional difficulty falling asleep (i.e., more than 30 mins).(1) Complains of nightly difficulty falling asleep.(2)

5. Insomnia: Middle of the Night Restlessness, being disturbed during the night, waking up.

No difficulty.(0) Complains of being restless and disturbed during the night.(1) Waking during the night – any getting out of bed rates 2 (except for voiding).(2)

6. Insomnia: Early Hours of the Morning Waking up early and difficulty returning to sleep.

No difficulty.(0) Waking in early hours of the morning but goes back to sleep.(1) Unable to fall asleep again if he/she gets out of bed.(2)

7. Work and Activities Feelings of incapacity, fatigue, loss of interest in work/hobbies, decreased productivity.

No difficulty.(0) Thoughts and feelings of incapacity, fatigue or weakness related to activities, work or hobbies.(1) Loss of interest in activity, hobbies or work – directly reported or indirect listlessness, indecision (feels he/she has to push self).(2) Decrease in actual time spent in activities or decrease in productivity (e.g., doesn’t spend at least 3 hours/day in activities).(3) Stopped working because of present illness. Engages in no activities except routine chores, or fails to perform routine chores unassisted.(4)

8. Retardation Slowness of thought and speech, impaired ability to concentrate, decreased motor activity.

Normal speech and thought.(0) Slight retardation noticeable in interview.(1) Obvious retardation in interview.(2) Interview difficult.(3) Complete stupor.(4)

9. Agitation Restlessness, fidgeting, moving about, hand wringing, nail biting.

None.(0) Fidgetiness.(1) Playing with hands, hair, etc.(2) Moving about, can’t sit still.(3) Hand wringing, nail biting, hair-pulling, biting of lips.(4)

10. Anxiety: Psychic Subjective tension, irritability, worrying, apprehension, fears.

No difficulty.(0) Subjective tension and irritability.(1) Worrying about minor matters.(2) Apprehensive attitude apparent in face or speech.(3) Fears expressed without questioning.(4)

11. Anxiety: Somatic Physiological signs of anxiety (e.g., dry mouth, GI upset, palpitations, headaches, hyperventilation, sweating, frequent urination).

12. Somatic Symptoms: Gastro-intestinal Loss of appetite, heavy feeling in abdomen, needing laxatives.

None.(0) Loss of appetite but eating without staff encouragement. Heavy feelings in abdomen.(1) Difficulty eating without staff urging. Requests or requires laxatives or medication for bowels or GI symptoms.(2)

13. Somatic Symptoms: General Heaviness in limbs, back or head; backaches, headaches, muscle aches; loss of energy and fatigability.

None.(0) Heaviness in limbs, back or head. Backaches, headaches, muscle aches. Loss of energy and fatigability.(1) Any clear-cut symptom rates 2.(2)

14. Genital Symptoms Loss of libido, menstrual disturbances.

Absent.(0) Mild.(1) Severe.(2)

15. Hypochondriasis Focus on bodily symptoms, preoccupation with health, complaints, requests for help.

Not present.(0) Self-absorption (bodily).(1) Preoccupation with health.(2) Frequent complaints, requests for help, etc.(3) Hypochondriacal delusions.(4)

16. Loss of Weight (Patient’s Report) Estimate of weight loss associated with the present illness.

No weight loss.(0) Probable weight loss associated with present illness.(1) Definite (according to patient) weight loss.(2)

17. Insight Acknowledgement of being depressed and ill.

Acknowledges being depressed and ill.(0) Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc.(1) Denies being ill at all.(2)

Hamilton Rating Scale for Depression (HAM-D/HDRS)

Your HAM-D Score