HAMILTON DEPRESSION RATING SCALE (HAM-D)

Name Name * First Last
Account Number *
Directions:

For each item select the one “cue” which best characterizes you currently.
DEPRESSED MOOD
(Gloomy attitude, pessimism about the future,
feeling of sadness, tendency to weep)

DEPRESSED MOOD
(Gloomy attitude, pessimism about the future,
feeling of sadness, tendency to weep) Absent. Sadness. Occasional weeping. Frequent weeping. Extreme symptoms.
FEELINGS OF GUILT

FEELINGS OF GUILT Absent. Self-reproach, feel I have let people down. Ideas of guilt. Present illness is a punishment; delusions of guilt. Hallucinations of guilt.
SUICIDE

SUICIDE Absent. Feel life is not worth living. Wishing you were dead or any thoughts of possible death to self. Ideas or gestures of suicide. Attempts at suicide.
INSOMNIA: MIDDLE OF THE NIGHT

INSOMNIA: MIDDLE OF THE NIGHT No difficulty falling asleep. Occasional difficulty falling asleep, i.e. more than 1 ⁄2 hour. Nightly difficulty falling asleep.
INSOMNIA: EARLY IN THE NIGHT

INSOMNIA: EARLY IN THE NIGHT No difficulty. Occasionally restless and disturbed during the night. Frequent restlessness, getting out of bed.
INSOMNIA: EARLY HOURS OF THE MORNING

INSOMNIA: EARLY HOURS OF THE MORNING No difficulty. Waking in the early hours of the morning but able to go back to sleep. Unable to fall asleep again if you get out of bed.
WORK AND ACTIVITIES

WORK AND ACTIVITIES No difficulty. Thoughts and feelings of incapacity, fatigue or weakness related to activities, work or hobbies. Loss of interest in activity, hobbies or work, have to push myself for activities. Spending less than 3 hours a day in activities (job or hobbies). Stopped working because of present illness. No activities except routine chores, or cannot perform routine chores unassisted.
STUPOR: SLOWNESS OF THOUGHT/SPEECH

STUPOR: SLOWNESS OF THOUGHT/SPEECH Normal speech and thought. Slight slowness of thought, speech and activity. Obvious apathy, impaired ability to concentrate. Complete stupor.
AGITATION
(Restlessness associated with anxiety.)

AGITATION
(Restlessness associated with anxiety.) None. Slight fidgeting. Occasional agitation. Frequent playing with hands, hair, biting of lips, etc.
ANXIETY - PSYCHIC

ANXIETY - PSYCHIC No difficulty. Slight tension and irritability. Worrying about minor matters. Apprehensive attitude. Severely fearful.
ANXIETY - SOMATIC
Gastrointestinal, indigestion
Cardiovascular, palpitation, Headaches
Respiratory, Genito-urinary, etc.

ANXIETY - SOMATIC
Gastrointestinal, indigestion
Cardiovascular, palpitation, Headaches
Respiratory, Genito-urinary, etc. No difficulty. Mild. Moderate. Severe. Incapacitating.

Such as: dry mouth, indigestion, diarrhea, palpitations, headaches, hyperventilation, sweating
SOMATIC SYMPTOMS - GASTROINTESTINAL
(Loss of appetite, heavy feeling in abdomen; constipation)

SOMATIC SYMPTOMS - GASTROINTESTINAL
(Loss of appetite, heavy feeling in abdomen; constipation) None. Loss of appetite but still eating. Heavy feeling in abdomen. Difficulty eating without encouraging. Need medication for gastrointestinal problems.
SOMATIC SYMPTOMS - GENERAL
(Heaviness in limbs, back or head; diffuse backache; loss of energy and fatigue)

SOMATIC SYMPTOMS - GENERAL
(Heaviness in limbs, back or head; diffuse backache; loss of energy and fatigue) None Mild. Severe.
GENITAL SYMPTOMS
(Loss of libido, menstrual disturbances)

GENITAL SYMPTOMS
(Loss of libido, menstrual disturbances) None. Mild. Severe.
HYPOCHONDRIASIS
(anxiety about health)

HYPOCHONDRIASIS
(anxiety about health) None. Slight preoccupation with health. Frequently preoccupied with health. Severely worried about health.
WEIGHT LOSS

WEIGHT LOSS No weight loss. Probable weight loss associated with present illness. Definite weight loss (greater than 2lb loss in a week).

HAMILTON DEPRESSION RATING SCALE (HAM-D)

HAMILTON DEPRESSION RATING SCALE (HAM-D)

Directions: