The Hamilton Depression Rating Scale (HAM-D)

              The Hamilton Depression Rating Scale (HAM-D) is a measure or test that determines if a person’s brain is suffering from depression.  All information is found in the original scientific journal published by the author of the test, Hamilton. `Previously it has been proven to accurately show levels of depression before, during, and after treatment. The measure consists of 21 concepts or items but only the first 17 of them are scored.  The HAM-D measure is the most widely used depression scale clinically.

Scoring

A score of zero to seven is considered to be normal and a score of above 20 is considered to be clinically abnormal in one article summarizing the rating scale. Another interpretation of the score is a HAM-D score level of depression: 10 – 13 is mild; 14-17 is mild to moderate; greater than 17 moderates to severe.

Measurement

The test measures depressed mood, feelings of guilt, suicide, anxiety symptoms, physiological symptoms, insomnia at night, insomnia during the day, hypochondriasis, genital symptoms, difficulty at work and activities, intellectual loss, loss of weight, agitation, and insight.

              The measure was originally not structured and not intended to use clinically, but since release has been structuralized and used clinically for diagnosis. It was originally developed for hospital inpatients, and there is an emphasis on melancholic and physical symptoms of depression. They would use it to measure progress in subtypes during and after treatment. A limitation to the measure is that atypical symptoms of depression (e.g., hypersomnia, hyperphagia) are not assessed.

Misconceptions and uses

              One misconception is that the measure can tell severity of depression and it cannot. What it can do is subtype it to help with what symptoms are showing more. An appropriate way to use this measure is to be aware of what it is intended for and its current uses. It should only be used by those trained on it and its use and not used to diagnose others by the general public. This is because the value of the questionnaire depends highly on the skill of the interviewer.

Previous research shows internal, inter-rater and retest reliability estimates are good enough for the global score but are not for individual items. The measure is widely available and not protected by copyright.

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