Calculators / Depression and mood
HAM-D 17
Hamilton Depression Rating Scale, 17 items. Clinician-rated depression severity.
Members Library
The HAM-D 17 calculator is in the Library.
Every rating scale calculator comes with the Library, along with the prescribing guides, medication handouts, DSM-5 criteria and sheets, and the Guide Builder.
Use it for
- Rating the severity of depression in a patient who already has the diagnosis.
- Tracking response and remission during treatment.
- Research and trial work, where it is the long-standing comparator.
Do not use it for
- Screening or diagnosing depression. It was built to rate severity once the diagnosis is made.
- Atypical depression. It scores insomnia and weight loss, not hypersomnia or weight gain, so it can under-rate atypical features.
- Unstructured use by an untrained rater. Interrater reliability depends on a structured interview such as the SIGH-D or the GRID-HAMD.
Rate each item from the interview and from what staff and family report. Most clinicians cover the past week. Use the highest rating that fits and score only what is present.
Rating anchors on this page are abbreviated from the published scale. Use the full anchors in the SIGH-D or GRID-HAMD for trial work.
HAM-D 17
Answer the questions to see the result.
This calculator adds up the score in your browser. Nothing you enter is stored or sent.
More about the HAM-D 17
About the HAM-D 17What it is and what it is for
Max Hamilton published the depression scale in 1960 for patients who already had a diagnosis of depression. A clinician interviews the person, adds what staff or family report, and rates 17 items. Nine are rated 0 to 4 and eight are rated 0 to 2, so the total runs from 0 to 52.
It became the standard outcome measure in antidepressant trials for decades. Response is a drop of 50% or more, and remission is a score of 7 or below. It is weighted toward insomnia, anxiety and somatic complaints, so it describes some kinds of depression better than others.
How to use itGiving it and scoring it
Interview the person and use what family or staff report. Rate each item from 0 to 4, or from 0 to 2 for the eight items that have only three levels. Do not score more than the item allows. Add all 17 items.
Use the same rater and the same structured interview for each follow-up, so the change means something.
Interpreting the scoreScore ranges and what they suggest
| Score | What it suggests | Usual response |
|---|---|---|
| 0 to 7 | Normal or in remissionThe usual remission threshold in trials. | If in treatment, continue it and plan maintenance. |
| 8 to 13 | MildResidual or mild symptoms. | If treated, optimize before calling it a remission. If untreated, consider psychotherapy or watchful waiting. |
| 14 to 18 | ModerateClear symptoms with impairment. | Active treatment. Assess response at the next visits. |
| 19 to 22 | SevereMarked symptoms. | Active treatment, close follow-up and a safety review. |
| 23 to 52 | Very severeMarked symptoms and impairment. | Treat urgently. Consider psychotic features and the level of care. |
These are the bands most often quoted. Hamilton did not publish cutoffs. A study that matched HDRS scores to clinicians' global severity ratings (Zimmerman 2013) proposed higher cutpoints: remission 7 or below, mild 8 to 16, moderate 17 to 23, severe 24 or more. The page shows both.
Pearls and pitfallsTips and common mistakes
- Always record the baseline total at the start of treatment. Response and remission both depend on it.
- Read the suicide item (3) on its own, whatever the total.
- A single item can move the total several points. A fall driven by the three sleep items can come from a sleep drug.
- If the person denies illness (item 17 = 2) the other ratings are often under-reported. Ask someone who knows them.
- For a quick self-report measure of the same domain, use the PHQ-9.
EvidenceAccuracy and reliability
- Hamilton (1960) developed the scale in hospitalized patients with depression, and it has since been the most widely used clinician-rated depression measure in trials.
- Interrater reliability is good with a structured interview, and drops without one. The SIGH-D and GRID-HAMD were built to fix that.
- A common criticism is its weight on somatic and anxiety items and its poor coverage of atypical features and anhedonia. The scale is nonetheless the comparator for most registered antidepressant trials.
- Zimmerman and colleagues (2013) matched HDRS ranges to clinicians' global severity ratings and proposed remission at 7 or below, mild 8 to 16, moderate 17 to 23 and severe 24 or above.
Source, license and referencesWhere it comes from
The Hamilton Depression Rating Scale was published by Max Hamilton in 1960 and is widely reproduced in the public domain. The SIGH-D and GRID-HAMD are separate structured versions with their own terms. Anchors on this page are abbreviated from the published scale.
- Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62.
- 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.
- Zimmerman M, Posternak MA, Chelminski I. Is the cutoff to define remission on the Hamilton Rating Scale for Depression too high? J Nerv Ment Dis. 2005;193(3):170-175.
- Williams JBW. A structured interview guide for the Hamilton Depression Rating Scale. Arch Gen Psychiatry. 1988;45(8):742-747.
- Kennedy SH, Lam RW, McIntyre RS, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder. Can J Psychiatry. 2016;61(9):540-560.