Hamilton Depression Rating Scale (HAM-D)

The Hamilton Depression Rating Scale (HDRS), commonly known as HAM-D, is one of the oldest and most widely used clinical assessment tools worldwide, designed to assess the severity of symptoms in patients already diagnosed with major depressive disorder. It is crucial to note that this is not a self-report tool; it must be administered by a trained clinician via a structured interview. The most common version, the HAM-D17, consists of 17 items that evaluate depressive symptomatology. These items cover core domains such as depressed mood, feelings of guilt, and suicidal ideation, as well as somatic symptoms (sleep disturbances like early, middle, and late insomnia; somatic anxiety; appetite/weight loss) and cognitive/behavioral symptoms (psychomotor agitation or retardation, psychic anxiety, and insight). Each item is scored on a 3- or 5-point scale (0-2 or 0-4) based on severity. The total score (range 0-52 for HAM-D17) is used to quantify depression severity (e.g., 0-7 is considered normal, 8-13 mild, 14-18 moderate, 19-22 severe, and ≥23 very severe) and is frequently used in clinical trials to measure treatment efficacy and symptom change over time, rather than for initial diagnosis.