Clinical Overview
The Hamilton Rating Scale for Depression (HAM-D) is a clinician-administered assessment instrument originally developed by Dr. Max Hamilton in 1960 to evaluate the severity of depression in patients already diagnosed with depressive disorders. Widely regarded as the gold standard for depression severity assessment in clinical research, this comprehensive scale has become one of the most extensively used outcome measures in psychiatric clinical trials and practice. The HAM-D systematically evaluates both psychological and somatic symptoms of depression including depressed mood, guilt, suicidal ideation, sleep disturbances, work and activities, psychomotor symptoms, anxiety, and somatic complaints. Available in multiple versions including the original 21-item scale and the commonly used 17-item version (HAM-D-17), this instrument requires trained clinician administration and incorporates both patient self-report and clinical observation. The scale’s emphasis on somatic symptoms and its sensitivity to treatment effects have established it as the primary endpoint in most antidepressant clinical trials.
Key Validation Points
- Gold Standard Recognition – Established as the reference standard for depression severity assessment with over 60 years of validation research
- Excellent Inter-Rater Reliability – Demonstrated high inter-rater reliability (ICC > 0.90) when administered by trained clinicians across diverse settings
- Treatment Sensitivity – Proven responsiveness to antidepressant medications and psychotherapy with established minimal clinically important differences
- Regulatory Validation – Widely accepted by FDA and international regulatory agencies as primary efficacy endpoint for antidepressant clinical trials
- Extensive Research Foundation – Used in thousands of clinical trials and research studies with the most comprehensive validation database of any depression scale
- International Standardization – Translated into numerous languages with established training protocols and inter-rater reliability standards worldwide
Primary Use Cases
- Clinical Trial Primary Endpoint – Gold standard outcome measure for antidepressant efficacy trials and pharmaceutical research studies
- Depression Severity Assessment – Comprehensive evaluation of depression symptom severity with established cut-off points for mild, moderate, and severe depression
- Treatment Response Monitoring – Longitudinal assessment of symptom changes following antidepressant treatment with proven sensitivity to therapeutic effects
- Clinical Research Applications – Primary outcome measure for depression research studies requiring clinician-rated assessment
- Regulatory Approval Studies – Widely accepted by FDA and international regulatory agencies as primary efficacy endpoint for antidepressant approval
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