Hamilton Depression Rating Scale (HDRS). Take a free online course without registration.

The Hamilton scale for assessing depression is one of the most widely used clinical tools for determining the severity of depressive states. It helps the physician objectively evaluate both emotional and physical manifestations of depression: mood, anxiety, sleep, appetite, energy level, cognitive functions, and somatic symptoms.

The questionnaire consists of a set of items, each of which is rated on a specific scale. The final score reflects the degree of depression: from mild to severe. The scale is used for initial diagnosis, monitoring the dynamics of the condition, and assessing the effectiveness of treatment.

1. Depressed mood (sadness, hopelessness, helplessness, worthlessness):
0 – absent
1 – reported only on questioning
2 – reported spontaneously and verbally
3 – reported non-verbally (facial expression, posture, voice, crying tendencies)
4 – reported spontaneously both verbally and non-verbally
2. Feelings of guilt:
0 – absent
1 – self-reproach, feeling of having let others down
2 – guilt ideas, ruminations about past mistakes
3 – considers illness a punishment, delusions of guilt
4 – hears accusing voices or sees threatening hallucinations
3. Suicidal thoughts / attempts:
0 – absent
1 – feels life is not worth living
2 – thinks about the possibility of death
3 – suicidal ideas or attempts
4 – suicide attempts
4. Difficulty falling asleep:
0 – normal sleep onset
1 – occasional difficulty falling asleep
2 – persistent difficulty falling asleep
5. Disturbed sleep duration:
0 – absent
1 – restless, disturbed night
2 – waking up during the night
6. Disturbed awakening:
0 – absent
1 – early morning awakening
2 – unable to fall asleep again after waking
7. Work and daily activities:
0 – no problems
1 – fatigue, weakness, decreased activity
2 – loss of interest in activities or work
8. Psychomotor retardation:
0 – normal speech and thinking
1 – slight retardation
2 – clear retardation
3 – difficulty conducting the interview
4 – stupor
9. Agitation:
0 – absent
1 – restlessness
2 – constant hand movements, touching hair, etc.
3 – cannot sit still
4 – pulling hair, biting nails or lips
10. Anxiety (psychic):
0 – absent
1 – subjective tension, irritability
2 – worry over trifles
3 – anxiety noticeable in face or speech
4 – panic
11. Anxiety (somatic):
0 – absent
1 – mild
2 – moderate
3 – severe
4 – condition uncorrectable
12. Gastrointestinal somatic symptoms:
0 – absent
1 – loss of appetite, abdominal heaviness
2 – difficulty eating, need for laxatives
13. General somatic symptoms:
0 – absent
1 – heaviness in limbs, pain
2 – marked symptoms
14. Sexual dysfunction:

15. Hypochondriasis:
0 – absent
1 – self-absorption
2 – preoccupation with health
3 – frequent complaints, requests for help
4 – hypochondriacal delusion
16. Weight loss:
0 – no weight loss
1 – probably related to illness
2 – definite weight loss
3 – cannot be assessed
17. Insight:
0 – acknowledges illness
1 – attributes illness to fatigue, diet, climate
2 – denies illness