Hamilton Rating Scale for Depression

The Hamilton Rating Scale for Depression (HRSD), also known as the Hamilton Depression Rating Scale (HDRS) or abbreviated to HAM-D, is a multiple choice questionnaire that clinicians may use to rate the severity of a patient's major depression. Max Hamilton originally published the scale in 1960 and reviewed and evaluated it in 1966, 1967, 1969, and 1980. Initially considered the "Gold Standard", there is increased criticism that it is flawed both as a test instrument and in its conceptual basis.

The questionnaire rates the severity of symptoms observed in depression such as low mood, insomnia, agitation, anxiety and weight loss. The questionnaire is presently one of the most commonly used scales for rating depression in medical research.

The clinician must choose the possible responses to each question by interviewing the patient and by observing the patient's symptoms. Each question has between 3-5 possible responses which increase in severity. In the original scale published in 1960, the first 17 questions contribute to the total score (HRSD-17). Questions 18-21 are recorded to give further information about the depression (such as whether diurnal variation or paranoid symptoms are present), but are not part of the scale. A structured interview guide for the questionnaire is available.

Although Hamilton's original scale had 17 questions, others later developed HRSD scales with different numbers of questions, the greatest of which is 29 (HRSD-29). Clinicians can use the HRSD in place of, or in conjunction with, the Montgomery-Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), the Zung Self-Rating Depression Scale, the Wechsler Depression Rating Scale, the Raskin Depression Rating Scale, the Inventory of Depressive Symptomatology (IDS), the Quick Inventory of Depressive Symptomatology (QIDS), and other questionnaires.