Commentary on the Hamilton Rating Scale for Depression: 60+ Years Old and Still Relevant to the Assessment of Antidepressant Treatment Outcomes

In early 1960, approximately 9 months before John F. Kennedy was elected President of the United States, a 48-year-old psychiatrist from the University of Leeds in the United Kingdom named Max Hamilton, M.B.B.S, D.P.M., published a paper in the Journal of Neurology, Neurosurgery and Psychiatry describing a new scale to assess the severity of an episode of depression.1 Within a decade this scale, soon to be known as the Hamilton Rating Scale for Depression (HRSD) or—less elegantly—the HAM-D—had become the gold standard for measuring outcome in clinical trials of novel antidepressant medications. When later asked about why he chose to publish his paradigm-shifting scale in such an obscure journal, Hamilton modestly (and apparently truthfully) replied: “They were the only one who would take it”.