Hamilton depression scale (HAM-D)

Introduction

Alias: Hamilton rating scale for depression (HRS-D).

The most widely used depression scale & the 'gold standard' for other depression scales.

Advantages

• useful for monitoring a depressed state over time & evaluating the effects of therapy

Disadvantages

• less effective for the diagnosis of depression
• overemphasis on somatic & neurovegetative symptoms
• underemphasis on mood, affective & cognitive changes of depression
• in the elderly, the HAM-D over-reports changes in psychomotor activity & cognitive complaints
• the HAM-D is unreliable in patients with dementia
• no standardized questions
• depends on the skill of the interviewer to collect information & make rating decisions

Procedure

The evaluation is based on a semistructured interview. Several forms of the HAM-D exist with different numbers of symptom ratings. Most forms have 17 items (some versions have 21) with ratings along a continuum of 0-4 or 0-2 intensity & frequency within the past few days.

The items include assessment of:

• psychomotor retardation
• insomnia
• mood
• insight

More general terms

• screening for depression (includes depression assessment tools)
• depression scale