HAMILTON DEPRESSION RATING SCALE - 24 item
(to be completed by a trained clinician)

       DATE:           TIME (24hr): 

1. Depressed Mood
[]   0 = Absent.
[]   1 = These feeling states indicated only on questioning.
[]   2 = These feeling states spontaneously reported verbally.
[]   3 = Communicates feeling states non-verbally - i.e., through facial expression, posture, voice, and tendency to weep.
[]   4 = Patient reports virtually only these feeling states in his spontaneous verbal and non-verbal communication.

2. Work and Activities
[]   0 = No difficulty.
[]   1 = Thoughts and feelings of incapacity, fatigue or weakness related to activities; work or hobbies.
[]   2 = Loss of interest in activities; hobbies or work - either directly reported by patient, or indirect in listlessness, indecision and vacillation (feels he has to push self to work or activities).
[]   3 = Decrease in actual time spent in activities or decrease in productivity. In hospital rate 3 if patient does not spend at least three hours a day in activities (hospital job or hobbies) exclusive of ward chores.
[]   4 = Stopped working because of present illness. In hospital, rate 4 if patient engages in no activities except ward chores, or if patient fails to perform ward chores unassisted.

3. Social Withdrawal
[]   0 = Interacts with other people as usual.
[]   1 = Less interested in socializing with others but continues to do so.
[]   2 = Interacting less with other people in social (optional) situations.
[]   3 = Interacting less with other people in work or family situations (i.e. where this is necessary).
[]   4 = Marked withdrawal from others in family or work situations.

4. Genital Symptoms
[]   0 = Absent.
[]   1 = Mild.
[]   2 = Severe.

5. Somatic Symptoms - GI
[]   0 = None.
[]   1 = Loss of appetite but eating without staff
encouragement. Heavy feelings in abdomen.
[]   2 = Difficulty eating without staff urging. Requests or requires laxatives or medication for bowels or medication for G.I. symptoms.

6. Loss of Weight
[]   0 = No weight loss.
[]   1 = Probable weight loss associated with present illness.
[]   2 = Definite (according to patient) weight loss.

7. Weight Gain
[]   0 = No weight gain.
[]   1 = Probable weight gain due to current depression.
[]   2 = Definite (according to patient) weight gain due to depression.

8. Appetite Increase
[]   0 = No increase in appetite.
[]   1 = Wants to eat a little more than usual.
[]   2 = Wants to eat somewhat more than normal.
[]   3 = Wants to eat much more than usual.

9. Increased Eating
[]   0 = Is not eating more than usual.
[]   1 = Is eating a little more than usual.
[]   2 = Is eating somewhat more than usual.
[]   3 = Is eating much more than normal.

10. Carbohydrate Craving
[]   0 = No change in food preference or consumption.
[]   1 = Craving or eating more carbohydrates (starches or sugars) than before.
[]   2 = Craving or eating much more carbohydrates than before.
[]   3 = Irresistible craving or eating of sweets or starches.

11. Insomnia - Early
[]   0 = No difficulty falling asleep.
[]   1 = Complains or occasional difficulty falling asleep - i.e., more than 1/2 hour.
[]   2 = Complains of nightly difficulty falling asleep.

12. Insomnia - Middle
[]   0 = No difficulty.
[]   1 = Patient complains of being restless and disturbed during the night.
[]   2 = Waking during the night - any getting out of bed rates 2 (except for purposes of voiding).

13. Insomnia - late
[]   0 = No difficulty.
[]   1 = Waking in early hours of the morning but goes back to sleep.
[]   2 = Unable to fall asleep again if he gets out of bed.

14. Hypersomnia
0 = No increase in sleep length.
[]   1 = At least 1 hour increase in sleep length.
[]   2 = 2+ hour increase.
[]   3 = 3+ hour increase.
[]   4 = 4+ hour increase.

15. Somatic Symptoms - General
[]   0 = None.
[]   1 = Heaviness in limbs, back or head. Backaches, headache, muscle aches. Loss of energy and fatigability.
[]   2 = Any clear-cut symptom rates 2.

16. Fatigability
[]   0 = Does not feel more fatigued than usual.
[]   1 = Feels more fatigued than usual but this has not impaired function significantly; less frequent than in (2).
[]   2 = More fatigued than usual; at least one hour a day; at least three days a week.
[]   3 = Fatigued much of the time most days.
[]   4 = Fatigued almost all the time.

17. Feelings of Guilt
[]   0 = Absent.
[]   1 = Self reproach, feels he has let people down.
[]   2 = Ideas of guilt or rumination over past errors or sinful deeds.
[]   3 = Present illness is a punishment. Delusions of guilt.
[]   4 = Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations.

18. Suicide
[]   0 = Absent.
[]   1 = Feels life is not worth living.
[]   2 = Wishes he were dead or any thoughts of possible death to self.
[]   3 = Suicide ideas or gestures.
[]   4 = Attempts at suicide (any serious attempt rates 4).

19. Anxiety - Psychic
[]   0 = No difficulty.
[]   1 = Subjective tension and irritability.
[]   2 = Worrying about minor matters.
[]   3 = Apprehensive attitude apparent in face or speech.
[]   4 = Fears expressed without questioning.

20. Anxiety - Somatic
[]   0 = Absent.
[]   1 = Mild.
[]   2 = Moderate.
[]   3 = Severe.
[]   4 = Incapacitating.

21. Hypochondriasis
[]   0 = Not present
[]   1 = Self-absorption (bodily).
[]   2 = Preoccupation with health.
[]   3 = Frequent complaints, requests for help, etc.
[]   4 = Hypochondriacal delusions.

22. Insight
[]   0 = Acknowledges being depressed and ill.
[]   1 = Acknowledges illness but attributes cause to bad food, climate, over work, virus, need for rest, etc.
[]   2 = Denies being ill at all.

23. Motor Retardation
[]   0 = Normal speech and thought.
[]   1 = Slight retardation at interview.
[]   2 = Obvious retardation at interview.
[]   3 = Interview difficult.
[]   4 = Complete stupor.

24. Agitation
[]   0 = None.
[]   1 = Fidgetiness.
[]   2 = Playing with hands, hair, etc.
[]   3 = Moving about can't sit still.
[]   4 = Hand wringing, nail biting, hair pulling, biting of lips.

    TOTAL  HDR:  

(HDR  maximum score = 15)

0   -     4    normal, depending on age, education, complaints
5   -     8    mild
8   -   11    moderate
12 -  15    severe

TEXT FOR YOUR RECORDS - click here:

Electronic form developed at the Palo Alto Veterans Affairs Hospital
  by Wes Ashford, M.D., Ph.D.
Neither the HDR nor this electronic form are protected by copyright.
There is no individual or agency that takes responsibility for the results obtained
with this test or this form.