Is the HAM-D self-report or clinician-administered?

The HAM-D is clinician-administered, not a self-report measure. A trained clinician conducts a semi-structured interview and assigns ratings based on observed behaviour and reported symptoms. Because self-completion is not valid, it cannot substitute for the PHQ-9 in routine screening workflows.

What does a HAM-D score of 7 or below mean?

A score of ≤7 is the consensus remission criterion established by Frank et al. (1991) and widely adopted as the FDA benchmark in antidepressant approval trials. It reflects minimal residual symptoms, though it does not confirm full functional recovery or absence of future recurrence risk.

What are the severity bands for the HAM-D 17-item version?

Based on Zimmerman et al. (2013), empirically derived bands for the HAM-D17 are: 0–7 (no depression / remission), 8–16 (mild), 17–23 (moderate), and ≥24 (severe). Moderate HAM-D scores (≥17) are typically required for entry into antidepressant efficacy trials.

Can the HAM-D be used to diagnose depression?

No. The HAM-D measures the severity of depressive symptoms in people already identified as depressed — it is not a diagnostic tool. Diagnosis requires a clinical assessment using structured criteria (e.g., DSM-5 or ICD-11); the HAM-D then quantifies symptom burden and tracks change over time.

How is response defined on the HAM-D?

Treatment response is conventionally defined as a ≥50% reduction from the baseline HAM-D score. This threshold, alongside the ≤7 remission criterion, forms the dual-endpoint standard used by regulatory agencies when evaluating antidepressant efficacy in randomized controlled trials.

Interactive InterpreterLast reviewed Jun 3, 2026

HAM-D: Hamilton Depression Rating Scale

The HAM-D (Hamilton Depression Rating Scale) is a 17-item clinician-rated scale that measures the severity of depressive symptoms over the past week through a semi-structured interview. The benchmark outcome measure in antidepressant clinical trials, with ≤7 as the remission criterion.

For professional reference, research, and education only. Not for diagnosis or medical advice.

On this page
HAM-D Score Interpreter What does the HAM-D measure?How do you give the HAM-D?How do you score and interpret the HAM-D?HAM-D vs PHQ-9 Psychometric properties Limitations References FAQ
At a glance
Billing codes
CPT 96127
In HiBoop
Not offered (reference only)
Timeline
1. 1960
  Max Hamilton publishes the original rating scale in J Neurol Neurosurg Psychiatry, establishing 17 core items.
2. 1967
  Hamilton publishes a revised version of the scale, refining item definitions and instructions.
3. 1991
  Frank et al. establish consensus definitions for remission (HAM-D ≤7), response, recovery, and recurrence in the landmark Arch Gen Psychiatry paper.
4. 2013
  Zimmerman et al. publish empirically derived severity cutoffs (mild 8–16, moderate 17–23, severe ≥24) using ROC analysis in a large outpatient sample.

HAM-D Score Interpreter

Total score (HAM-D17)
052
Enter a total score to see its range.

17 items; clinician-rated via semi-structured interview covering the past week. Items scored 0–4 or 0–2 depending on the symptom. Total range 0–52.

Total score (HAM-D17)	Interpretation
24+	Severe depressionScores ≥24 indicate severe depressive illness. Clinically significant impairment is expected; urgent evaluation and treatment review are warranted.
17–23	Moderate depressionScores 17–23 indicate moderate severity. This range typically meets the minimum threshold for entry into antidepressant efficacy trials.
8–16	Mild depressionScores 8–16 indicate mild depressive symptoms. Monitoring and low-intensity interventions may be appropriate depending on clinical context.
0–7	Remission / minimal symptomsScores 0–7 reflect the consensus remission criterion. Residual symptoms may still be present; continued monitoring supports relapse prevention.

Zimmerman M et al. (2013). J Affect Disord. 150(2):384-8. Severity ranges per empirically derived ROC-based cutoffs. Remission criterion per Frank E et al. (1991). Arch Gen Psychiatry. 48(9):851-5.

The HAM-D (Hamilton Depression Rating Scale) is a 17-item clinician-rated scale for measuring the severity of depression ^[1]. It is a standard outcome measure in antidepressant trials, where treatment response and remission are defined on its total ^[2].

What does the HAM-D measure?

The HAM-D (Hamilton Depression Rating Scale), also called the HDRS or HRSD, is a 17-item clinician-administered rating scale developed by Max Hamilton to quantify the severity of depressive illness ^[1]. It is widely used as an observer-rated outcome measure in antidepressant clinical trials.

Items assess mood, guilt, suicidality, insomnia, work and activity, psychomotor retardation, agitation, anxiety, somatic symptoms, and vegetative features including appetite, libido, and weight. It is particularly sensitive to melancholic features. The HAM-D measures the severity of depressive symptoms in people already identified as depressed; it is not a diagnostic tool.

How do you give the HAM-D?

The HAM-D is administered by a trained clinician through a semi-structured interview, with ratings based on observed behaviour and reported symptoms. It captures symptoms over the past week. Client self-completion is not valid, so it cannot substitute for a self-report questionnaire such as the PHQ-9 in routine screening workflows.

For educational reference only. HAM-D is clinician-administered, scores should be derived from a structured clinical interview, not self-report.

How do you score and interpret the HAM-D?

Items are rated on either a 5-point scale (0–4) or a 3-point scale (0–2), depending on the symptom. The 17-item version (HAM-D17) is standard, yielding total scores from 0 to 52.

HAM-D17 severity ranges recommended by a study of 627 outpatients with major depressive disorder ^[3]:

Total score	Severity
0–7	No depression
8–16	Mild depression
17–23	Moderate depression
≥24	Severe depression

A ≥50% reduction from baseline defines treatment response; a score of ≤7 defines remission ^[2], the two endpoints that anchor FDA antidepressant approval trials. A score of ≤7 reflects minimal residual symptoms but does not confirm full functional recovery.

HAM-D vs PHQ-9

Both measure depression severity, but they serve different purposes and settings.

PHQ-9

Client-completed, no clinician time required
9 items, fast for routine screening
Suited to primary care and high-volume settings
Commonly billed under CPT 96127 when used for measurement-based care
Rarely the primary endpoint in antidepressant trials

HAM-D

Observer-rated, captures behavioural signs, not just subjective report
Standard outcome measure in antidepressant clinical trials
Sensitive to melancholic features (vegetative symptoms)
Remission criterion (≤7) widely accepted in research
Requires a trained clinician, not suitable for self-report

Psychometric properties

Severity cutoffs. In 627 outpatients with major depressive disorder, ROC analysis against clinician CGI severity ratings found the HAM-D17 cutoffs that best separated mild from moderate depression (17) and moderate from severe depression (24) ^[3].
Scalability and versions. In a placebo-controlled antidepressant trial, the brief 6-item HAM-D6 was superior to the HAM-D17, HAM-D21 and HAM-D24 in scalability and in separating drug from placebo remission rates; longer versions showed smaller discriminating validity ^[4].

Limitations

Not diagnostic. The HAM-D quantifies severity in people already identified as depressed; diagnosis requires a structured clinical assessment.
Clinician time and training. It requires a trained rater and a semi-structured interview, so it is impractical for high-volume screening.
Multidimensional total. Longer versions add items that weaken their ability to separate drug from placebo; the 6-item core scale performed better in one trial ^[4].
Cutoff generalizability. The severity ranges come from a single outpatient practice whose participants were mostly white, female and insured ^[3].

For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.

Billing
In the US, the HAM-D: Hamilton Depression Rating Scale is usually billed under these CPT codes. Payer rules vary.
96127Brief Emotional/Behavioural Assessment
More regional billing codes
References
1. 1.
  Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56-62.View source
2. 2.
  Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW, Rush AJ, Weissman MM. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Arch Gen Psychiatry. 1991;48(9):851-5.View source
3. 3.
  Zimmerman M, Martinez JH, Young D, Chelminski I, Dalrymple K. Severity classification on the Hamilton Depression Rating Scale. J Affect Disord. 2013;150(2):384-8.View source
4. 4.
  Kyle PR, Lemming OM, Timmerby N, Søndergaard S, Andreasson K, Bech P. The validity of the different versions of the Hamilton Depression Scale in separating remission rates of placebo and antidepressants in clinical trials of major depression. J Clin Psychopharmacol. 2016;36(5):453-6.View source
Related
Assessments
Common paths
- Cognitive Behavioural Therapy
  CBT and the other main psychotherapies outperformed care as usual and waiting list in a network meta-analysis of 331 RCTs with 34,285 participants.
  Cuijpers P, et al. World Psychiatry. 2021;20(2):283–93.
- Acceptance & Commitment Therapy
  ACT reduced depressive symptoms compared with control groups in a meta-analysis of 18 studies with 1,088 participants.
  Bai Z, et al. J Affect Disord. 2020;260:728–37.

FAQ

Is the HAM-D self-report or clinician-administered?
The HAM-D is clinician-administered, not a self-report measure. A trained clinician conducts a semi-structured interview and assigns ratings based on observed behaviour and reported symptoms. Because self-completion is not valid, it cannot substitute for the PHQ-9 in routine screening workflows.
What does a HAM-D score of 7 or below mean?
A score of ≤7 is the consensus remission criterion established by Frank et al. (1991) and widely adopted as the FDA benchmark in antidepressant approval trials. It reflects minimal residual symptoms, though it does not confirm full functional recovery or absence of future recurrence risk.
What are the severity bands for the HAM-D 17-item version?
Based on Zimmerman et al. (2013), empirically derived bands for the HAM-D17 are: 0–7 (no depression / remission), 8–16 (mild), 17–23 (moderate), and ≥24 (severe). Moderate HAM-D scores (≥17) are typically required for entry into antidepressant efficacy trials.
Can the HAM-D be used to diagnose depression?
No. The HAM-D measures the severity of depressive symptoms in people already identified as depressed — it is not a diagnostic tool. Diagnosis requires a clinical assessment using structured criteria (e.g., DSM-5 or ICD-11); the HAM-D then quantifies symptom burden and tracks change over time.
How is response defined on the HAM-D?
Treatment response is conventionally defined as a ≥50% reduction from the baseline HAM-D score. This threshold, alongside the ≤7 remission criterion, forms the dual-endpoint standard used by regulatory agencies when evaluating antidepressant efficacy in randomized controlled trials.

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