Hamilton Depression Rating Scale (HDRS)

Patient’s Name Date of First Report
Diagnosis Date of This Report
Therapy
Instructions For each item check the box next to the response that best characterizes the patient.
Depressed Mood
0 Absent. Feeling of sadness, hopelessness, helplessness, worthlessness.
1 These feeling states indicated only on questioning.
2 These feeling state spontaneously reported verbally.
3 Communicates feeling states nonverbally – 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.
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.
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 (only serious attempt rates 4)
Insomnia Early
0 No difficulty.
1 Complains of occasional difficulty falling asleep – i.e., more than ½ hour
2 Complains of nightly difficulty falling asleep.
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).
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 gets out of bed.
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 activity; hobbies or work – either directly reported by patient, or indirect in listlessness, indecision or 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.
Retardation
0 Normal speech and thought. Slowness of thought and speech; impaired ability to concentrate; decreased motor activity
1 Slight retardation at interview.
2 Obvious retardation at interview.
3 Interview difficult.
4 Complete stupor.
 
Agitation
0 None.
1 “Playing with” hands, hair, etc
2 Hand-wringing, nail-biting, hair-pulling, biting of lips
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.
Anxiety Somatic
0 Absent. Physiological concomitants of anxiety, such as: Gastrointestinal – dry mouth, wind, indigestion, diarrhea, craps, belching. Cardiovascular – palpitations, headaches. Respiratory – hyperventilation, sighing. Urinary frequency. Sweating.
1 Mild.
2 Moderate.
3 Severe.
4 Incapacitating.
 
Somatic Symptoms Gastrointestinal
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 GI symptoms.
Somatic Symptoms General
0 None.
1 Heaviness in limbs, back or head.  Backaches, headache, muscle aches.  Loss of energy or fatigability.
2 Any clear-cut symptom rates 2
Genital Symptoms
0 Absent. Symptoms such as: Loss of libido. Menstrual disturbances.
1 Mild.
2 Severe.
 
Hypochondriasis
0 Not present.
1 Self-absorption (bodily).
2 Preoccupation with health.
3 Frequent complaints, requests for help, etc.
4 Hypochondriacal delusions.
Loss of Weight (Answer only A or B)
  A. When rating by history:
0 No weight loss.
1 Probable weight loss associated with present illness.
2 Definite (according ot patient) weight loss.
  B. On weekly ratings by ward psychiatrist, when actual weight changes are measured
0 Less then 1 lb weight loss in week.
1 Greater then 1 lb weight loss in week.
2 Greater than 2 lb weight loss  in week.
Insight
0 Acknowledges being depressed and ill.
1 Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc.
2 Denies being ill at all
Diurnal Variation
  Note whether symptoms are worse in the morning or evening.
  No variation.
  Worse in AM.
  Worse in PM.
   
  When present, rate the variation.
1 Mild.
2 Severe.
Depersonalization And Derealization
0 Absent. Such as: Feelings of unreality. Nihillstic ideas.
1 Mild.
2 Moderate.
3 Severe.
4 Incapacitating.

 

 
Paranoid Symptoms
0 None.
1 Suspicious.
2 Ideas of reference.
3 Delusions of reference and persecution.
Obsessional and Compulsive Symptoms
0 Absent.
1 Mild.
2 Severe.
Total Score:
 

Global Research & Consulting
515 Main Street, Olean, NY 14760
Telephone: 716-373-1094, Fax: 716-373-1153
Email: support@globalresearchandconsulting.com