Hamilton Depression Scale

The Hamilton Depression Scale (HDS) is also referred to as Hamilton Rating Scale for Depression (HRSD) or Hamilton Depression Rating Scale. It is an inventory of questions or test that is employed to detect and identify the intensity or severity of the signs and symptoms of depression in patients who have been diagnosed with clinical depression.

HDS was initially developed or created by Max Hamilton as a test or quiz that can be used along with patient interviews to assess the severity of the signs and symptoms of depression. Hence the name Hamilton Depression Scale. It was first developed in the year 1960 and revised in the year 1967.

You can find a link to an online version of the Hamilton Depression Scale below.

More Information on HDS

HDS, or HRSD as it is commonly known, comprises 21 questions. These 21 questions cover topics pertinent to symptoms of depression. These include symptoms which are based on emotions, such as guilt, experiencing a depressed state of mind, suicidal thoughts, as well as physical or somatic symptoms, such as no sleep or sleeplessness and experiencing and imagining that one is suffering various health conditions, a condition called hypochondriasis.

The Hamilton Depression Scale can be administered on children as well as adults. It is generally used to measure or examine the decrease in the intensity of depression in patients who are on medication. HDS is normally used initially while evaluating the patient for the first time, and later on is administered during follow-up visits in an attempt to assess the improvement in symptoms of depression after starting on medication. Results of HDS administered during follow up visits help physicians taper or alter the quantity of antidepressant medication prescribed.

The Hamilton Depression Scale is extremely effective and is generally considered to be a yardstick or measure for other depression scales.

Versions of the Scale

The initial version of HDS comprises 17 units which are scored or rated by the interviewer or health care practitioner. The second version or the revised version of HDS consists of 21 questions - the additional four questions cover symptoms of depression in relation to paranoia and obsession. These four questions do not assess the severity or intensity of depression like the remaining 17 items.

The 17 items that are included in HDS requires interviewers to assess and rate patients on all symptoms of depression ranging from emotional to physical like feelings of guilt, professional or work-related problems, to lack of sex drive, increased sense of failure, pessimistic attitude, negativity, constant bouts of sobbing and crying, insomnia, decrease or loss of appetite, weight loss, and suicidal tendencies or attempted suicide.

Understanding the Ratings

The first version of the Hamilton Depression Scale consists of two categories. The first category consists of nine units that are scored or rated on a five-point scale, where progressive points between zero and four are awarded to each of the nine items (out of the total 17) depending upon the absence, presence and severity of depression symptoms.

  • Zero points indicate non-depressed symptoms.
  • One point indicates apprehension regarding the existence of depression symptoms.
  • Two points indicate existence or presence of mild or minimum level of depression symptoms.
  • Three points indicate moderate extent of depression symptoms.
  • Four points indicate severe depression symptoms.

The second category consists of eight units or items that are rated on a three-point scale, where progressive points between zero and two are awarded to each of the eight items.

  • Zero points indicate non-depressed symptoms.
  • One point indicates apprehension regarding the presence of depressive symptoms.
  • Two points indicate existence of depressive symptoms.

The total score or points are tallied and, according to one formula, the results can be interpreted as follows:

  • Scores from 0 to 6 represent normalcy.
  • Scores from 7 to 17 are representative of mild form of depression.
  • Scores from 18 to 24 are representative of moderate or average depression.
  • Scores above or greater than 24 represent severe or intense depression.

Though the Hamilton Depression Scale is easy to read, understand, and interpret, it is recommended to be used by interviewers who are primarily health care practitioners to rate patients already diagnosed with clinical depression.

HDS is used primarily to establish the severity of depression in patients at the time of initial diagnosis, and is administered again later to assess the effect of medication on symptoms. The dosage of medications is then changed or altered during further follow-up visits.

Check out an online version of the Hamilton Depression Scale. Use the 3rd link on the page, termed “Your current level of depression (AutoSIGH)”.






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