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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.[1] Max Hamilton originally published the scale in 1960[2] and reviewed and evaluated it in 1966,[3] 1967,[4] 1969,[5] and 1980.[6] Initially considered the "Gold Standard", there is increased criticism that it is flawed both as a test instrument and in its conceptual basis.[7]

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).[8] 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.[9]

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).[10][11][12][13] 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,[14] the Raskin Depression Rating Scale,[15] the Inventory of Depressive Symptomatology (IDS), the Quick Inventory of Depressive Symptomatology (QIDS),[16] and other questionnaires.[17]


  1. Hedlund JL, Viewig BW (1979) The Hamilton rating scale for depression: a comprehensive review. Journal of Operational Psychiatry 10:149-165
  2. Hamilton, M (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry. 23: 56-62 PMID 14399272
  3. Hamilton M (1966) Assessment of change in psychiatric state by means of rating scales. Proceedings of the Royal Society of Medicine 59 (Suppl. 1): 10-13 PMID 5922401
  4. Hamilton, M (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6: 278-96 PMID 6080235
  5. Hamilton, M (1969) Standardised assessment and recording of depressive symptoms. Psychiatria, Neurologia, Neurochirurgia. 72:201-205 PMID 5792061
  6. Hamilton, M (1980) Rating depressive patients. Journal of Clinical Psychiatry. 41: 21-24 PMID 7440521
  7. Bagby RM, Ryder AG, Schuller DR, Marshall MB (2004). "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?". American Journal of Psychiatry 161 (12): 2163–77. doi:10.1176/appi.ajp.161.12.2163. PMID 15569884.
  8. HDRS-17: Hamilton Depression Rating Scale (HDRS) in Official website of Servier. Retrieved June 30, 2008.
  9. Williams JBW (1989) A structured interview guide for the Hamilton Depression Rating Scale. Archives of General Psychiatry 45: 742-747. PMID 3395203
  10. HRSD-7: 7-ITEM HAMILTON RATING SCALE FOR DEPRESSION: HAMD-7 in Official website of CANMAT: Canadian Network for Mood and Anxiety Treatments Accessed June 30, 2008, and McIntyre R, Kennedy S, Bagby RM, Bakish DJ (2002) Assessing full remission. Journal of Psychiatry and Neuroscience 27: 235-239 PMID 12174732
  11. HRSD-21: The Hamilton Rating Scale for Depression (to be administered by a health care professional) (presented as a service by GlaxoWellcome, February 1997) in UMass HealthNet: Consumer Health Resources for Massachusetts Residents: Official website of the Lamar Soutter Library, University of Massachusetts Medical School, Worcester, MA, 01655 USA. Retrieved June 27, 2008.
  12. HRSD-24: Hamilton Depression Rating Scale - 24 item (to be completed by a trained clinician) in FOCUS ON ALZHEIMER'S DISEASE: MEDAFILE; Site constructed and maintained by J. Wesson Ashford, M.D., Ph.D., Stanford / VA Alzheimer's Center, Palo Alto VA Hospital, 3801 Miranda Way, Palo Alto, CA 94304 USA. Retrieved June 27, 2008.
  13. HRSD-29: Williams JBW, Link MJ, Rosenthal NE, Terman M, Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders Version (SIGHSAD). New York Psychiatric Institute, New York, 1988
  14. Wechsler H, Grosser GH, Busfield BL Jr (1963) The depression rating scale: a quantitative approach to the assessment of depressive symptomatology. Archives of General Psychiatry. 9: 334-343 PMID 14045262
  15. Raskin A, Schulterbrandt J, Reatig N, McKeon JJ (1969) Replication of factors of psychopathology in interview, ward behavior and self-report ratings of hospitalized depressives. Journal of Nervous and Mental Diseases 148: 87-98 PMID 5768895
  16. Inventory of Depressive Symptomatology (IDS) & Quick Inventory of Depressive Symptomatology (QIDS) in IDS/QIDS: Instruments in English and Multiple Translations by the University of Pittsburgh Epidemiology Data Center, 2008. Retrieved June 27, 2008.
  17. Psychiatric Rating Scales for Depression in www.neurotransmitter.net website by Shawn M. Thomas. Retrieved June 30, 2008.

See also

  • Diagnostic classification and rating scales used in psychiatry
  • Diagnostic and Statistical Manual of Mental Disorders
  • List of psychology topics
  • Receiver operating characteristic

External links

de:Hamilton-Skala ru:Шкала Гамильтона для оценки депрессии