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Hamilton Depression Rating Scale (HAM-D 17-item)

The 17-item Hamilton Depression Rating Scale is a clinician-rated measure of depression severity scored 0–52. Recommended severity bands (Zimmerman 2013) are 0–7 no depression, 8–16 mild, 17–23 moderate and ≥24 severe; remission is usually defined as ≤7.

1. Depressed mood (sadness, hopeless, helpless, worthless): 0: Absent (0); 1: Indicated only on questioning (1); 2: Spontaneously reported verbally (2); 3: Communicated non-verbally (facial expression, posture, voice, tendency to weep) (3); 4: Virtually only these feelings reported, verbally and non-verbally (4)
2. Feelings of guilt: 0: Absent (0); 1: Self-reproach, feels he/she has let people down (1); 2: Ideas of guilt or rumination over past errors or sinful deeds (2); 3: Present illness is a punishment; delusions of guilt (3); 4: Hears accusatory or denunciatory voices and/or threatening visual hallucinations (4)
3. Suicide: 0: Absent (0); 1: Feels life is not worth living (1); 2: Wishes he/she were dead or any thoughts of possible death to self (2); 3: Suicidal ideas or gesture (3); 4: Attempts at suicide (4)
4. Insomnia: early (difficulty falling asleep): 0: No difficulty falling asleep (0); 1: Occasional difficulty falling asleep (more than ½ hour) (1); 2: Nightly difficulty falling asleep (2)
5. Insomnia: middle (waking during the night): 0: No difficulty (0); 1: Restless and disturbed during the night (1); 2: Waking during the night; any getting out of bed (except to void) (2)
6. Insomnia: late (early-morning waking): 0: No difficulty (0); 1: Waking in early hours but goes back to sleep (1); 2: Unable to fall asleep again if he/she gets out of bed (2)
7. Work and activities: 0: No difficulty (0); 1: Thoughts and feelings of incapacity, fatigue or weakness related to activities, work or hobbies (1); 2: Loss of interest in activities, hobbies or work (reported, or listlessness, indecision, vacillation) (2); 3: Decrease in actual time spent in activities or decrease in productivity (3); 4: Stopped working because of present illness (4)
8. Retardation (slowness of thought and speech, impaired concentration, decreased motor activity): 0: Normal speech and thought (0); 1: Slight retardation at interview (1); 2: Obvious retardation at interview (2); 3: Interview difficult (3); 4: Complete stupor (4)
9. Agitation: 0: None (0); 1: Fidgetiness (1); 2: Playing with hands, hair, etc. (2); 3: Moving about, can't sit still (3); 4: Hand wringing, nail biting, hair-pulling, biting of lips (4)
10. Anxiety: psychic: 0: No difficulty (0); 1: Subjective tension and irritability (1); 2: Worrying about minor matters (2); 3: Apprehensive attitude apparent in face or speech (3); 4: Fears expressed without questioning (4)
11. Anxiety: somatic (GI, CV, respiratory, urinary frequency, sweating): 0: Absent (0); 1: Mild (1); 2: Moderate (2); 3: Severe (3); 4: Incapacitating (4)
12. Somatic symptoms: gastrointestinal: 0: None (0); 1: Loss of appetite but eating without encouragement (1); 2: Difficulty eating without urging; requests laxatives or GI medication (2)
13. General somatic symptoms: 0: None (0); 1: Heaviness in limbs, back or head; backaches, headache, muscle aches; loss of energy and fatigability (1); 2: Any clear-cut symptom (2)
14. Genital symptoms (loss of libido, menstrual disturbance): 0: Absent (0); 1: Mild (1); 2: Severe (2)
15. Hypochondriasis: 0: Not present (0); 1: Self-absorption (bodily) (1); 2: Preoccupation with health (2); 3: Frequent complaints, requests for help, etc. (3); 4: Hypochondriacal delusions (4)
16. Loss of weight: 0: No weight loss (or <1 lb/week if measured) (0); 1: Probable weight loss associated with present illness (or >1 lb/week) (1); 2: Definite weight loss according to patient (or >2 lb/week) (2)
17. Insight: 0: Acknowledges being depressed and ill (0); 1: Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc. (1); 2: Denies being ill at all (2)

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Interpretation

Result	Meaning
0–7	No depression (remission)
8–16	Mild
17–23	Moderate
≥ 24	Severe

Formula

Sum of 17 clinician-rated items. Items 1, 2, 3, 7, 8, 9, 10, 11 and 15 are scored 0–4; items 4, 5, 6, 12, 13, 14, 16 and 17 are scored 0–2. Range 0–52.

Clinical pearls

The HAM-D is clinician-rated from an interview covering the past week; a structured interview guide (e.g. SIGH-D) improves reliability.
Response in trials is usually a ≥50% fall from baseline; remission is usually a total ≤7.
The scale weights somatic and sleep symptoms heavily, so medical illness and sedating drugs can inflate the score.

Examples

hamd 17 items 3,2,1,2,1,1,3,1,1,2,2,1,2,1,1,1,0 HAM-D: depressed mood 2, guilt 1, suicide 0, early insomnia 2, middle insomnia 1, late insomnia 1, work 2, retardation 1, agitation 1, psychic anxiety 2, somatic anxiety 1, GI 1, general somatic 1, genital 1, hypochondriasis 0, weight loss 1, insight 0 hamilton depression score all items zero

FAQ

What HAM-D score means severe depression?

Using the empirically derived bands of Zimmerman et al. (2013), a 17-item HAM-D of 24 or more is severe, 17–23 moderate, 8–16 mild and 0–7 no depression.

What HAM-D score is remission?

Most trials define remission as a 17-item HAM-D total of 7 or less, and response as a 50% or greater reduction from baseline.

How is the HAM-D different from the PHQ-9?

The HAM-D is rated by a clinician after an interview; the PHQ-9 is a patient self-report questionnaire. They are not interchangeable point for point.

Evidence

Psychiatry & Substance Use · Reviewed 2026-10-14 · Methodology