Hamilton Depression Rating Scale, 17 item (HAM-D-17)

The Hamilton Depression Rating Scale, 17 item (HAM-D-17) is a simple, clinician-administered tool used to assess symptoms of depression experienced by a patient in the past week. The HAM-D-17 is one of the most widely used depression severity rating scales in the world.
Description: The Hamilton Depression Rating Scale, 17 item (HAM-D-17) is a simple, clinician-administered tool used to assess symptoms of depression experienced by a patient in the past week. The HAM-D-17 is one of the most widely used depression severity rating scales in the world.
Disease States: Major depressive disorder
Validated Uses: Treatment Monitoring & Evaluation, Symptom Severity
Administration Method: Clinician-report
Time to administer: 16-30 minutes
Commonly used in: Clinical Trials & Research, Clinical Practice
Detailed Description: The original and most widely used version of the Hamilton Depression Scale consists of 17 items, each rated on a 0 to 2 or 0 to 4 scale according to severity.1,4 Originally developed for use in hospital inpatients, the HAM-D-17 emphasizes the melancholic and physical symptoms of depressive disorders.5 The scale is not intended for diagnostic purposes, but rather to quantify the severity of symptoms present in a patient who already has a depressive disorder diagnosis.1 For the HAM-D-17, a score of 0 to 7 is generally accepted as within normal limits (or in clinical remission).5 A score of 20 or higher indicates at least moderate severity and is usually required for entry into a clinical trial.3,5 While the scale was originally designed for completion after an unstructured clinical interview, there are now semi-structured interview guides available.1,5,10
Scale Validity: According to a validation study conducted in 70 adult patients with depressive symptoms, inter-rater reliability of the HAM-D-17 is approximately 90%.1
Alternative Versions: Numerous versions with varying lengths exist, including HAM-D-17 (described here), HAM-D-21, HAM-D-24, HAM-D-29, HAM-D-6, HAM-D-7, and HAM-D-8.5 The 21-item version (HAM-D-21) includes 4 additional items intended to subtype the depression: diurnal variation, derealization, paranoid symptoms, and obsessional symptoms.11 The 24-item version includes the same 21 items, along with items assessing helplessness, hopelessness, and worthlessness.11 Please note that the HAM-D and all its iterations are sometimes referred to by the acronym HDRS.5,*
Cited Limitations: Despite its universal use and the widespread belief that the HAM-D-17 is the “gold standard” for measuring depression severity, some researchers claim that the tool is both conceptually and psychometrically flawed.6 For example, because of its emphasis on somatic symptoms, the HAM-D-17 can exaggerate depression severity in patients who have a concurrent medical illness.4,12 Additional limitations of the HAM-D-17 include its failure to assess atypical symptoms of depression (eg, hypersomnia, hyperphagia)5 and its tendency to confound the intensity and frequency of symptoms.1 Finally, the HAM-D-17 is not well-suited for use in bipolar depression due to the atypical symptom presentation that sometimes occurs in these patients.5,13


*Although the original 17-item version of the HAM-D is described here, we include information about alternative versions for your general awareness and convenience. You may see these alternative versions used by different practitioners or in clinical trial or research settings.

Supporting references for the filters are as follows:
Disease States: Major depressive disorder1-3; Validated Uses: Treatment Monitoring & Evaluation,1,3-5 Symptom Severity3-5; Administration Method: Clinician-report1,3,5; Time to administer: 16–30 minutes5; Commonly used in: Clinical Trials & Research,6-8 Clinical Practice6,9,10 


This resource is intended for educational purposes only and is intended for US healthcare professionals. Healthcare professionals should use independent medical judgment. All decisions regarding patient care must be handled by a healthcare professional and be made based on the unique needs of each patient. 


ABBV-US-01552-MC, Version 1.0
Approved 03/2024
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  1. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62. doi:10.1136/jnnp.23.1.56 
  2. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967;6(4):278-296. doi:10.1111/j.2044-8260.1967.tb00530.x 
  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):384-388. doi:10.1016/j.jad.2013.04.028 
  4. Rush AJ, First MB, Blacker D. Handbook of Psychiatric Measures. American Psychiatric Publishing; 2008.  
  5. Lam R, Michalak EE, Swinson RP. Assessment Scales in Depression, Mania and Anxiety. Taylor & Francis Group; 2005.  
  6. Bagby RM, Ryder AG, Schuller DR, Marshall MB. The Hamilton Depression Rating Scale: has the gold standard become a lead weight? Am J Psychiatry. 2004;161(12):2163-2177. doi:10.1176/appi.ajp.161.12.2163 
  7. Center for Drug Evaluation and Research. Major Depressive Disorder: Developing Drugs for Treatment (Guidance for Industry). Food and Drug Administration; 2018. 
  8. American Psychiatric Association. Practice Guideline for the Treatment of Patients With Major Depressive Disorder. American Psychiatric Association; 2010. 
  9. Trivedi MH, Rush AJ, Wisniewski SR, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28-40. doi:10.1176/appi.ajp.163.1.28 
  10. Williams JB. A structured interview guide for the Hamilton Depression Rating Scale. Arch Gen Psychiatry. 1988;45(8):742-747. doi:10.1001/archpsyc.1988.01800320058007 
  1. Williams JB. Standardizing the Hamilton Depression Rating Scale: past, present, and future. Eur Arch Psychiatry Clin Neurosci. 2001;251(Suppl 2):II6-112. doi:10.1007/BF03035120 
  2. Linden M, Borchelt M, Barnow S, Geiselmann B. The impact of somatic morbidity on the Hamilton Depression Rating Scale in the very old. Acta Psychiatr Scand. 1995;92:150-154. doi:10.1111/j.1600-0447.1995.tb09559.x 
  3. Sung G, Kim BN, Lee EH, Yu BH, Hong KS, Kim JH. Underestimating the severity of bipolar depression: a comparison of the Hamilton Depression Rating Scale items. J Affect Disord. 2012;136(3):425-429. doi:10.1016/j.jad.2011.11.007   

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