Psychiatry A

Hamilton Depression Rating Scale (HAM-D17)

Clinician-administered 17-item scale measuring depression severity. Standard outcome measure in antidepressant trials and clinical practice.

1. Depressed Mood*

2. Feelings of Guilt*

3. Suicidal Ideation*

4. Early Insomnia (difficulty falling asleep)*

5. Middle Insomnia (wakes during night)*

6. Late Insomnia (early morning waking)*

7. Work and Activities*

8. Retardation (psychomotor slowing)*

9. Agitation*

10. Anxiety (Psychic)*

11. Anxiety (Somatic — GI, cardiovascular, respiratory symptoms)*

12. Somatic Symptoms — GI*

13. Somatic Symptoms — General (fatigue, heaviness)*

14. Genital Symptoms (loss of libido, menstrual disturbance)*

15. Hypochondriasis*

16. Weight Loss*

17. Insight*

Score interpretation

No Depression 0–7

No clinically significant depression.

→ No specific treatment indicated. Reassess if symptoms change.

Mild Depression 8–13

Mild depressive episode.

→ Watchful waiting, guided self-help, or low-intensity psychological interventions.

Moderate Depression 14–18

Moderate depressive episode.

→ Antidepressant therapy and/or structured psychological therapy (CBT). Regular monitoring.

Severe Depression 19–22

Severe depressive episode.

→ Antidepressant therapy and psychological therapy. Consider psychiatric referral. Assess suicide risk.

Very Severe Depression 23–52

Very severe depression — high symptom burden.

→ Urgent psychiatric review. Consider inpatient admission. ECT may be indicated in refractory cases.

Interpretation bands for the HAM-D. Apply clinical judgement and local guidance.

Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62.
Zimmerman M et al. How many different ways to measure depression? The reliability, validity and interpretability of the HAM-D scoring scales. J Nerv Ment Dis. 2002;190(8):527-532.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.