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Standardizing the Hamilton Depression Rating Scale: past, present, and future

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Abstract

The Hamilton Depression Rating Scale (HAM-D) has become the most widely used depression severity rating scale in the world. It was originally published by Max Hamilton in 1960 to measure severity of depression in previously diagnosed depressed inpatients. Since that time, multiple versions of the scale have been created, although authors are rarely clear about which version they used. In addition, structured interview guides, self-report forms, and computerized versions have been developed in an effort to standardize administration of the scale and improve the psychometric characteristics of the individual items. The history of the development of these features is discussed, and the various versions of the scale are summarized in tables. This article is a fitting tribute to Per Bech, who has contributed so much to the assessment of depression severity.

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References

  • Bech P (1981) Rating scales for affective disorders: their validity and consistency. Acta Psychiatr Scand 64 (suppl 295): 1–101

    Google Scholar 

  • Bech P (1990) Psychometric developments of the Hamilton Scales: the spectrum of depression, dysthymia, and anxiety. In: Bech P, Coppen A (eds) The Hamilton Scales. Springer-Verlag, New York

    Google Scholar 

  • Bech P, Allerup P (1981) The Hamilton Depression Scale: evaluation of objectivity using logistic models. Acta Psychiatr Scand 63: 290–299

    Article  PubMed  CAS  Google Scholar 

  • Bech P, Allerup P, Reisby N, Gram LF (1984) Assessment of symptom change from improvement curves on the Hamilton depression scale in trials with antidepressants. Psychopharmacology (Berl) 84: 276–281

    Article  CAS  Google Scholar 

  • Bech P, Coppen A (1990) The Hamilton Scales. Springer-Verlag, New York

    Google Scholar 

  • Bech P, Gram LF, Dein E, Jacobsen O, Vitger J, Bolwig TG (1975) Quantitative rating of depression states: correlation between clinical assessment, Beck’s self-rating scale and Hamilton’s objective rating scale. Acta Psychiat Scand 51:161–170

    Article  PubMed  CAS  Google Scholar 

  • Bech P, Kastrup M, Rafaelsen OJ (1986) Mini-compendium of rating scales for anxiety, depression, mania, schizophrenia with corresponding DSM-III syndromes. Acta Psychiatr Scand (suppl) 326: 1–37

    CAS  Google Scholar 

  • Bech P, Rafaelsen OJ (1980) The use of rating scales exemplified by a comparison of the Hamilton and the Bech Rafaelsen Melancholia Scale. Acta Psychiatr Scand 62 (suppl 185): 128–132

    Article  Google Scholar 

  • Carr AC, Anceill RJ, Ghosh A, Margo A (1981) Direct assessment of depression by microcomputer: a feasibility study. Acta Psychiatr Scand 64:415–422

    Article  PubMed  CAS  Google Scholar 

  • Carroll BJ, Fielding JM, Blashki TG (1973) Depression rating scales. A critical review. Arch Gen Psychiatry 28:361–6

    CAS  Google Scholar 

  • Carroll BJ, Feinberg M, Smouse PE, Rawson SG, Greden JF (1981) The Carroll Rating Scale for Depression. I. Development, reliability and validation. Br J Psychiatry 138:194–200

    Article  PubMed  CAS  Google Scholar 

  • Endicott J, Cohen J, Nee J, Fleiss J, Sarantakos S (1981) Hamilton Depression Rating Scale: extracted from regular and change versions of the Schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 38: 98–103

    PubMed  CAS  Google Scholar 

  • Faries D, Herrera J, Rayamajhi J, DeBrota D, Demitrack M, Potter WZ (2000) The responsiveness of the Hamilton Depression Rating Scale. J of Psychiatric Research 34: 3–10

    Article  CAS  Google Scholar 

  • Gelenberg AJ, Wojcik JD, Falk WE, Baldessarini RJ, Zeisel SH, Schoenfeld D, Mok GS (1990) Tyrosine for depression: a double-blind trial. JAffDis 19:125–132

    CAS  Google Scholar 

  • Gibbons RD, Clark DC, Kupfer DJ (1993) Exactly what does the Hamilton Depression Rating Scale measure? J Psychiat Res 27: 259–273

    Article  PubMed  CAS  Google Scholar 

  • Guy W (1976) Assessment manual for psychopharmacology. (Department of Health and Human Services Publication No. 76-338). Washington, DC: US Government Printing Office

    Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23: 56–62

    Article  PubMed  CAS  Google Scholar 

  • Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6: 278–296

    PubMed  CAS  Google Scholar 

  • Hedlund JL, Vieweg BW (1979) The Hamilton Rating Scale for Depression: a comprehensive review. J Oper Psychiatry 2:149–164

    Google Scholar 

  • Klein DF (1974) Endogenomorphic depression — a conceptual and terminological revision. Arch Gen Psychiat 31:447–454

    PubMed  CAS  Google Scholar 

  • Klerman GL, Weissman MM, Rounsaville BJ, Chevron ES (1984) Interview format for the Hamilton Rating Scale for Depression. In: Klerman GL, Weissman MM, Rounsaville BJ, Chevron ES (eds) Interpersonal Psychotherapy of Depression. Basic Books, Appendix, pp 223–233

  • Kobak KA, Reynolds WR, Rosenfeld R, Greist JH (1990) Development and validation of a computer administered Hamilton Depression Rating Scale. Psychological Assessment 2: 56–63

    Article  Google Scholar 

  • Kobak KA, Mundt JC, Greist JH, Katzelnick DJ, Jefferson, JW (2000) Computer assessment of depression: automating the Hamilton Depression Rating Scale. Drug Information Journal 34:145–156

    Google Scholar 

  • Kovacs M, Rush AJ, Beck AT, Hollon SD (1981) Depressed outpatients treated with cognitive therapy or pharmacotherapy. A one-year follow-up. Arch Gen Psychiatry 38:33–9

    PubMed  CAS  Google Scholar 

  • Maier W, Philipp M (1985) Improving the assessment of severity of depressive states: a reduction of the Hamilton Depression Scale. Pharmacopsychiat 18:114–115

    Article  Google Scholar 

  • Miller IW, Bishop S, Norman WH, Maddever H (1985) The modified Hamilton Rating Scale for Depression: reliability and validity. J Psychiat Res 14:131–142

    Article  CAS  Google Scholar 

  • Moberg PJ, Lazarus LW, Mesholam RI, Bilker W, Chuy IL, Neyman I, Markvart V (2001) Comparison of the standard and structured interview guide for the Hamilton Depression Rating Scale in depressed geriatric inpatients. Am J Geriatr Psychiatry 9(1): 35–40

    PubMed  CAS  Google Scholar 

  • Paykel ES (1985) The Clinical Interview for Depression: development, reliability and validity. J Affect Disord 9: 85–96

    Article  PubMed  CAS  Google Scholar 

  • Potts MK, Daniels M, Burnam MA, Wells KB (1990) A structured interview version of the Hamilton Depression Rating Scale: evidence of reliability and versatility of administration. J Psychiat Res 24: 335–350

    Article  PubMed  CAS  Google Scholar 

  • Rapp SR, Smith SS, Britt M (1990) Identifying comorbid depression in elderly medical patients: use of the Extracted Hamilton Depression Rating Scale. Psych Assess 2:243–247

    Article  Google Scholar 

  • Rehm LP, O’Hara MW (1985) Item characteristics of the Hamilton Rating Scale for Depression. J Psychiatr Res 19: 31–41

    Article  PubMed  CAS  Google Scholar 

  • Reynolds WM, Kobak KA (1995) Development and validation of the Hamilton Depression Inventory: a self-report version of the Hamilton Depression Rating Scale. Psychological Assessment 7:472–483

    Article  Google Scholar 

  • Riskind JH, Beck AT, Brown G, Steer RA (1987) Taking the measure of anxiety and depression: validity of the reconstructed Hamilton scales. J Nerv Ment Dis 175:474–479

    Article  PubMed  CAS  Google Scholar 

  • Roberts JN, Lei HH, Krishen A, Donahue RMJ, Jamerson BD, Bolden-Watson C, Houser TL (2001) Identifying sub-scales of the 31-item Hamilton Depression Scale. Poster presented at New Clinical Drug Evaluation Unit (NCDEU) meeting, May 28–31, 2001, Phoenix, AZ

  • Rosenthal SH, Klerman GL (1966) Endogenous features of depression in women. Can Psychiatr Assoc J11: 11–16

    Google Scholar 

  • Terman M (1988) On the question of mechanism in phototherapy for seasonal affective disorder: considerations of clinical efficacy and epidemiology. Journal of Biological Rhythms 3:155–172 [First published ref to SIGH-SAD]

    Article  PubMed  CAS  Google Scholar 

  • Terman M, Williams JBW, Terman JS (1991) Light therapy for winter depression: a clinician’s guide. In: Keller PA (ed) Innovations in Clinical Practice: A Source Book. vol. 10, Professional Resource Exchange, Sarasota, FL, pp 179–221

    Google Scholar 

  • Thase ME (1984) A Hamilton subscale for endogenomorphic depression. Hillside J Clin Psychiatry 6: 57–68

    PubMed  CAS  Google Scholar 

  • Thase ME, Frank E, Mallinger AG, Hamer T, Kupfer DJ (1992) Treatment of imipramine-resistant recurrent depression, III: Efficacy of monoamine oxidase inhibitors. J Clin Psychiatry 53: 5–11

    PubMed  CAS  Google Scholar 

  • Thase ME, Hersen M, Bellack AS, Himmelhoch JM, Kupfer DJ (1983) Validation of a Hamilton subscale for endogenomorphic depression. J Affect Disord 5: 267–278

    Article  PubMed  CAS  Google Scholar 

  • Whisman MA, Strosahl K, Fruzzetti AE, Schmaling KB, Jacobson NS, Miller DM (1989) A structured interview version of the Hamilton Rating Scale for Depression. Psych Assess 1:238–241

    Article  Google Scholar 

  • Williams JBW (1988) A structured interview guide for the Hamilton Depression Rating Scale. Arch Gen Psychiatry 45: 742–747

    PubMed  CAS  Google Scholar 

  • Williams JBW, Link M, Rosenthal NE, Amira L, Terman M (2000) Structured Interview Guide for the Hamilton Depression Rating Scale — Seasonal Affective Disorder Version (SIGH-SAD). New York State Psychiatric Institute, New York, NY

    Google Scholar 

  • Zitman FG, Mennen MFG, Griez E, Hooijer C (1990) The different versions of the Hamilton Depression Rating Scale. In: Bech P, Coppen A (eds) The Hamilton Scales (Psychopharmacology Series 9), Springer-Verlag, Berlin, Heidelberg, pp 28–34

    Google Scholar 

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Correspondence to Janet B. W. Williams.

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In honor of Per Bech, this report reviews the history of attempts to standardize the Hamilton Depression Rating Scale with different versions and interview guides.

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Williams, J.B.W. Standardizing the Hamilton Depression Rating Scale: past, present, and future. Eur Arch Psychiatry Clin Nuerosci 251 (Suppl 2), 6–12 (2001). https://doi.org/10.1007/BF03035120

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