Patient Name:______________________________________________________________ Date:_____________________

Hamilton Rating Scale for Depression (17-items)

Instructions: For each item select the “cue” which best characterizes the patient during the past week.
1. Depressed Mood
9. Agitation
(sadness, hopeless, helpless, worthless)
0 None
0 Absent
1 “Playing with” hand, hair, etc.
1 These feeling states indicated only on questioning
2 Hand-wringing, nail-biting, biting of lips
2 These feeling states spontaneously reported verbally
3 Communicates feeling states nonverbally, i.e., through facial
10. Anxiety - Psychic
expression, posture, voice and tendency to weep
0 No difficulty
4 Patient reports VIRTUALLY ONLY these feeling states in his
1 Subjective tension and irritability
spontaneous verbal and nonverbal communication
2 Worrying about minor matters
3 Apprehensive attitude apparent in face or speech
2. Feelings of Guilt
4 Fears expressed without questioning
0 Absent
1 Self-reproach, feels he has let people down
11. Anxiety - Somatic
2 Ideas of guilt or rumination over past errors or sinful deeds
0 Absent Physiological concomitants of anxiety such as:
3 Present illness is a punishment. Delusions of guilt
1 Mild Gastrointestinal - dry mouth, wind, indigestion,
4 Hears accusatory or denunciatory voices and/or experiences
2 Moderate diarrhea, cramps, belching
threatening visual hallucinations
3 Severe Cardiovascular – palpitations, headaches
4 Incapacitating Respiratory - hyperventilation, sighing
3. Suicide
Urinary frequency
0 Absent
Sweating
1 Feels life is not worth living
2 Wishes he were dead or any thoughts of possible death to self
12. Somatic Symptoms - Gastrointestinal
3 Suicide ideas or gesture
0 None
4 Attempts at suicide (any serious attempt rates 4)
1 Loss of appetite but eating without staff encouragement.
Heavy feelings in abdomen.
4. Insomnia - Early
2 Difficulty eating without staff urging. Requests or requires
0 No difficulty falling asleep
laxatives or medications for bowels or medication for G.I.
1 Complains of occasional difficulty falling asleep i.e., more than
symptoms.
½ hour
2 Complains of nightly difficulty falling asleep
13. Somatic Symptoms - General
0 None
5. Insomnia - Middle
1 Heaviness in limbs, back or head, backaches, headache,
0 No difficulty
muscle aches, loss of energy and fatigability
1 Patient complains of being restless and disturbed during the
2 Any clear-cut symptom rates 2
night
2 Waking during the night – any getting out of bed rates 2
14. Genital Symptoms
(except for purposes of voiding)
0 Absent 0 Not ascertained
1 Mild Symptoms such as: loss of libido,
6. Insomnia - Late
2 Severe menstrual disturbances
0 No difficulty
1 Waking in early hours of the morning but goes back to sleep
15. Hypochondriasis
2 Unable to fall asleep again if gets out of bed
0 Not present
1 Self-absorption (bodily)
7. Work and Activities
2 Preoccupation with health
0 No difficulty
3 Frequent complaints, requests for help, etc.
1 Thoughts and feelings of incapacity, fatigue or weakness
4 Hypochondriacal delusions
related to activities; work or hobbies
2 Loss of interest in activity; hobbies or work – either directly
16. Loss of Weight
reported by patient, or indirect in listlessness, indecision and
A. When Rating by History:
vacillation (feels he has to push self to work or activities)
0 No weight loss
3 Decrease in actual time spent in activities or decrease in
1 Probable weight loss associated with present illness
productivity. In hospital, rate 3 if patient does not spend at
2 Definite (according to patient) weight loss
least three hours a day in activities (hospital job or hobbies)
exclusive of ward chores.
B. On Weekly Ratings by Ward Psychiatrist, When Actual
4 Stopped working because of present illness. In hospital, rate 4
Changes are Measured:
if patient engages in no activities except ward chores, or if
0 Less than 1 lb. weight loss in week
patient fails to perform ward chores unassisted.
1 Greater than 1 lb. weight loss in week
2 Greater than 2 lb. weight loss in week
8. Retardation
(slowness of thought and speech; impaired ability to concentrate;
17. Insight
decreased motor activity)
0 Acknowledges being depressed and ill
0 Normal speech and thought
1 Acknowledges illness but attributes cause to bad food,
1 Slight retardation at interview
climate, overwork, virus, need for rest, etc.
2 Obvious retardation at interview
2 Denies being ill at all
3 Interview difficult
4 Complete stupor
Total Score:_____________________
Citation: Hamilton M: A rating scale for depression. Journal of Neurology, Neurosurgery and
Psychiatry 23:56-62, 1960