HAM-D: Hamilton Depression Rating Scale
Clinician-administered criterion standard for measuring depression severity. The benchmark outcome measure in antidepressant clinical trials, with ≤7 as the remission criterion.
HAM-D Score Interpreter
Scores 8–16 indicate mild depressive symptoms. Monitoring and low-intensity interventions may be appropriate depending on clinical context.
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. Educational reference only — not a diagnostic tool.
The HAM-D (HDRS) is the criterion-standard 17-item observer-rated scale for measuring depression severity. The benchmark outcome measure in 1,000+ antidepressant clinical trials and the standard for establishing treatment response and remission.
What is the HAM-D?
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 in 1960 to quantify the severity of depressive illness. It is the most widely used observer-rated scale for measuring depression in pharmacological research and has been used as the primary outcome measure in the majority of antidepressant clinical trials.
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. Items assess mood, guilt, suicidality, insomnia, work and activity, psychomotor retardation, agitation, anxiety, somatic symptoms, and vegetative features including appetite, libido, and weight.
The HAM-D is administered by a trained clinician through a semi-structured interview. It captures symptoms over the past week and is particularly sensitive to melancholic features. A ≥50% reduction from baseline defines treatment response; a score of ≤7 defines remission, the two endpoints that anchor FDA antidepressant approval trials.
HAM-D Score Interpreter
Enter a total HAM-D17 score to see severity classification and clinical context.
For educational reference only. HAM-D is clinician-administered, scores should be derived from a structured clinical interview, not self-report.
HAM-D17 Items
Each item is rated by a clinician based on a semi-structured interview covering the past week. Items 1–8, 10, 13–17 are scored 0–4; items 9, 11, 12 are scored 0–2.
Severity Bands
HAM-D17 cutoffs used in clinical trials and practice guidelines. A score of ≤7 is the standard FDA-accepted remission criterion.
HAM-D vs PHQ-9
Both measure depression severity, but they serve different purposes and settings.
- Patient-completed, no clinician time required
- 9 items, fast for routine screening
- Ideal for primary care and high-volume settings
- CPT billable (96127 with modifier) when used for MBC
- Not accepted as primary endpoint in pharma trials
- Observer-rated, captures behavioural signs, not just subjective report
- Criterion standard for antidepressant clinical trials (FDA)
- Sensitive to melancholic features (vegetative symptoms)
- Remission criterion (≤7) widely accepted in research
- Requires trained clinician, not suitable for patient self-report
Administer HAM-D in HiBoop
Structured clinician workflow, automated scoring, and longitudinal tracking built for measurement-based care.
References
- 1.Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56-62.View source
- 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.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.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
Frequently Asked Questions
Is the HAM-D self-report or clinician-administered?
The HAM-D is clinician-administered, not a self-report instrument. A trained clinician conducts a semi-structured interview and assigns ratings based on observed behaviour and reported symptoms. Because patient 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.
Related Assessments
Explore complementary clinical tools and screeners