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Hamilton Depression Rating Scale

The HDRS (also known as the Ham-D) is the most widely used clinician-administered depression assessment scale.

3 minutes to complete

Eligibility

The Hamilton Depression Rating Scale (HDRS) is a widely used clinical assessment tool for diagnosing and measuring the severity of depression. To be eligible to complete the HDRS, individuals must be aged 18 or older and have a diagnosis of major depressive disorder.

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Questions for Hamilton Depression Rating Scale

Questions

1.

DEPRESSED MOOD

(sadness, hopeless, helpless, worthless)

The answer should be a single choice:
  1. Absent.
  2. These feeling states indicated only on questioning.
  3. These feeling states spontaneously reported verbally.
  4. Communicates feeling states non-verbally i.e through facial expression, posture, voice and tendency to weep.
  5. Patient reports virtually only these feeling states in his/her spontaneous verbal and non-verbal communication.
2.

FEELINGS OF GUILT

The answer should be a single choice:
  1. Absent.
  2. Self reproach, feels he/she has let people down.
  3. Ideas of guilt or rumination over past errors or sinful deeds.
  4. Present illness is a punishment. Delusions of guilt.
  5. Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations.
3.

SUICIDE

The answer should be a single choice:
  1. Absent.
  2. Feels life is not worth living.
  3. Wishes he/she were dead or any thoughts of possible death to self.
  4. Ideas or gestures of suicide.
  5. Attempts at suicide.
4.

INSOMNIA: EARLY IN THE NIGHT

The answer should be a single choice:
  1. No difficulty falling asleep.
  2. Complains of occasional difficulty falling asleep, i.e. more than 1⁄2 hour.
  3. Complains of nightly difficulty falling asleep.
5.

INSOMNIA: MIDDLE OF THE NIGHT

The answer should be a single choice:
  1. No difficulty.
  2. Patient complains of being restless and disturbed during the night.
  3. Waking during the night.
6.

INSOMNIA: EARLY HOURS OF THE MORNING

The answer should be a single choice:
  1. No difficulty.
  2. Waking in early hours of the morning but goes back to sleep.
  3. Unable to fall asleep again if he/she gets out of bed.
7.

WORK AND ACTIVITIES

The answer should be a single choice:
  1. No difficulty.
  2. Thoughts and feelings of incapacity, fatigue or weakness related to activities, work or hobbies.
  3. Loss of interest in activity, hobbies or work – either directly reported by the patient or indirect in listlessness, indecision and vacillation (feels he/she has to push self to work or activities).
  4. Decrease in actual time spent in activities or decrease in productivity.
  5. Stopped working because of present illness.
8.

RETARDATION

(slowness of thought and speech, impaired ability to concentrate, decreased motor activity)

The answer should be a single choice:
  1. Normal speech and thought.
  2. Slight retardation during the interview.
  3. Obvious retardation during the interview.
  4. Interview difficult.
  5. Complete stupor.
9.

AGITATION

The answer should be a single choice:
  1. None.
  2. Fidgetiness.
  3. Playing with hands, hair, etc.
  4. Moving about, can’t sit still.
  5. Hand wringing, nail biting, hair-pulling, biting of lips.
10.

ANXIETY PSYCHIC

The answer should be a single choice:
  1. No difficulty.
  2. Subjective tension and irritability.
  3. Worrying about minor matters.
  4. Apprehensive attitude apparent in face or speech.
  5. Fears expressed without questioning.
11.

ANXIETY SOMATIC

The answer should be a single choice:
  1. Absent
  2. Mild
  3. Moderate
  4. Severe
  5. Incapacitating
12.

SOMATIC SYMPTOMS GASTRO-INTESTINAL

The answer should be a single choice:
  1. None.
  2. Loss of appetite but eating without staff encouragement. Heavy feelings in abdomen.
  3. Difficulty eating without staff urging. Requests or requires laxatives or medication for bowels or medication for gastro-intestinal symptoms.
13.

GENERAL SOMATIC SYMPTOMS

The answer should be a single choice:
  1. None.
  2. Heaviness in limbs, back or head. Backaches, headaches, muscle aches. Loss of energy and fatigability.
  3. Any clear-cut symptom.
14.

GENITAL SYMPTOMS

symptoms such as loss of libido, menstrual disturbances

The answer should be a single choice:
  1. Absent.
  2. Mild.
  3. Severe.
15.

HYPOCHONDRIASIS

symptoms such as loss of libido, menstrual disturbances

The answer should be a single choice:
  1. Not present.
  2. Self-absorption (bodily).
  3. Preoccupation with health.
  4. Frequent complaints, requests for help, etc.
  5. Hypochondriacal delusions.
16.

LOSS OF WEIGHT

symptoms such as loss of libido, menstrual disturbances

The answer should be a single choice:
  1. No weight loss.
  2. Probable weight loss associated with present illness.
  3. Definite weight loss.
  4. Not assessed.
17.

INSIGHT

symptoms such as loss of libido, menstrual disturbances

The answer should be a single choice:
  1. Acknowledges being depressed and ill.
  2. Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc.
  3. Denies being ill at all.

Scales Similar to Hamilton Depression Rating Scale

  • Hamilton Anxiety Rating Scale
  • Geriatric Depression Scale
  • Beck Depression Inventory
  • Patient Health Questionnaire
  • Montgomery-Asberg Depression Rating Scale
  • Zung Self-Rating Depression Scale

Here are some FAQs and additional information
on Hamilton Depression Rating Scale

What is the Hamilton Depression Rating Scale?

The Hamilton Depression Rating Scale (HDRS) is a widely used clinical tool that helps psychiatrists and other mental health professionals assess the severity of depressive symptoms in their patients.

How is the Hamilton Depression Rating Scale used?

The Hamilton Depression Rating Scale is used to assess the severity of depression by recording the patient's answers to a series of questions related to depression symptoms and behaviors. The scale also includes observations made by the clinician during the assessment.

What is the range of the Hamilton Depression Rating Scale?

The Hamilton Depression Rating Scale ranges from 0 to 53, with higher scores indicating more severe symptoms of depression. Scores of 20 or higher are considered clinically significant.

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