Hamilton Depression Rating Scale (HAM-D)

Addition of the selected points: Variable Points Depressed mood (gloomy attitude, pessimism about the future, feeling of sadness, tendency to weep) Absent 0 Sadness 1 Occasional weeping 2 Frequent weeping 3 Extreme symptoms 4 Feelings of guilt Absent 0 Self-reproach, feels he/she has let people down 1 Ideas of guilt 2 Present illness is a punishment; delusions of guilt 3 Hallucinations of guilt 4 Suicide Absent 0 Feels life is not worth living 1 Wishes he/she were dead 2 Suicidal ideas or gestures 3 Attempts at suicide 4 Initial insomnia (difficulty falling asleep) Absent 0 Occasional 1 Frequent 2 Insomnia during the night (restless, disturbed, waking at night) Absent 0 Occasional 1 Frequent 2 Delayed insomnia (waking in early hours of the morning and unable to fall asleep again) Absent 0 Occasional 1 Frequent 2 Work and interests No difficulty 0 Feelings of incapacity, listlessness, indecision and vacillation 1 Loss of interest in hobbies, decreased social activities 2 Productivity decreased 3 Unable to work, stopped working because of present illness only (absence from work after treatment or recovery may rate a lower score) 4 Retardation (slowness of thought, speech, and activity; apathy; stupor) Absent 0 Slight retardation at interview 1 Obvious retardation at interview 2 Interview difficult 3 Complete stupor 4 Agitation (restlessness associated with anxiety) Absent 0 Mild 1 Severe 2 Psychiatric anxiety Absent 0 Tension and irritability 1 Worrying about minor matters 2 Apprehensive attitude 3 Fears 4 Somatic anxiety (gastrointestinal, indigestion, cardiovascular, palpitations, headaches, respiratory, genitourinary, etc.) Absent 0 Mild 1 Moderate 2 Severe 3 Incapacitating 4 Gastrointestinal somatic symptoms (loss of appetite, heavy feeling in abdomen, constipation) Absent 0 Mild 1 Severe 2 General somatic symptoms (heaviness in limbs, back or head; diffuse backache; loss of energy, fatigability) Absent 0 Mild 1 Severe 2 Genital symptoms (loss of libido, menstrual disturbances) Absent 0 Mild 1 Severe 2 Hypochondriasis Not present 0 Bodily self-absorption 1 Preoccupation with health 2 Querulous attitude 3 Hypochondriacal delusions 4 Weight loss None 0 Slight 1 Obvious or severe 2 Insight (interpret in context of patient’s understanding and background) No loss 0 Partial or doubtful loss 1 Loss of insight 2