Hamilton Depression Rating Scale (HAMD-21)

Hamilton Depression Rating Scale (HAMD-21)

Welcome to Hamilton Depression Rating Scale (HAMD-21)

Instructions:

  • There is no time limit for this test. Please answer at your own pace.
  • This test consists of 21 questions in total.
  • The next question will appear automatically after you select an answer.
  • You can return to modify your answer using the "Previous" button.
  • All test results on this site are for reference only and do not constitute professional advice.

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Hamilton Depression Rating Scale (HAMD-21) | Professional Depression Severity Assessment Tool

1. Scale Introduction

The Hamilton Depression Rating Scale (HAMD) is an internationally recognized tool for assessing depressive symptoms, developed by British psychiatrist Max Hamilton in 1960. This 21-item version (of which the first 17 items are scored, and the last 4 items are used for auxiliary clinical information) covers multidimensional assessments including mood, cognition, and somatic symptoms. For over half a century, it has remained one of the most widely used tools in the field of depression assessment.

This scale is in the public domain and can be used for clinical evaluation, scientific research, and personal reference. The scale quantitatively evaluates the severity of depressive symptoms through standardized items, providing a reference basis for early screening, symptom monitoring, and treatment efficacy evaluation of depression.

2. Scale Structure and Scoring Method

This scale consists of 21 items, covering the following symptom dimensions:

  • Emotional Symptoms: Depressed mood, feelings of guilt, suicidal ideation, hopelessness, low self-esteem
  • Sleep Disturbances: Difficulty falling asleep, restless sleep, early awakening
  • Activity and Cognition: Decreased work and interests, retardation (slowing of thought/speech/movement), agitation, feelings of inadequacy
  • Anxiety Symptoms: Psychological anxiety, somatic anxiety
  • Somatic Symptoms: Gastrointestinal symptoms, general somatic symptoms, sexual symptoms, weight loss
  • Others: Hypochondriasis, insight, diurnal variation, depersonalization, paranoid symptoms, obsessive-compulsive symptoms

Scoring Instructions: The first 17 items are included in the total score (scored on 0-2 or 0-4 point scales), with a total score range of 0-52 points. Higher scores indicate more severe depressive symptoms. Items 18-21 (diurnal variation, depersonalization, paranoid symptoms, obsessive-compulsive symptoms) are not included in the total score and are used for auxiliary clinical observation.

3. Item Scoring Rules

This test consists of 21 questions, scored according to symptom severity:

  • 0-2 point scale items (Items 4, 5, 6, 12, 13, 14, 16): 0 = None; 1 = Mild/Suspected; 2 = Obvious/Severe
  • 0-4 point scale items (remaining 14 items): 0 = None; 1 = Mild; 2 = Moderate; 3 = Severe; 4 = Very Severe
  • Total Score Range: 0-52 points (higher scores indicate more severe symptoms)

4. Result Interpretation Criteria

  • 0-7 points: No depressive symptoms, good emotional state
  • 8-13 points: Mild depressive symptoms, recommend monitoring emotional changes
  • 14-18 points: Moderate depressive symptoms, recommend seeking professional help
  • 19-22 points: Severe depressive symptoms, strongly recommend medical consultation
  • ≥23 points: Very severe depressive symptoms, require urgent professional intervention

5. Applicable Scenarios

The Hamilton Depression Rating Scale is suitable for the following scenarios:

  • Individuals experiencing low mood, decreased interest, and other manifestations who wish to understand their depressive state
  • Assessment of symptom severity and monitoring of treatment efficacy in patients with depression
  • Mental health screening and standardized measurement in clinical research
  • Assessment of depressive symptoms in psychiatric outpatient/inpatient settings

6. Important Notes

  • Please answer based on your actual feelings over the past week
  • Results may be influenced by current emotional state; it is recommended to consider long-term patterns for a comprehensive judgment
  • The diagnosis of depression requires comprehensive evaluation by a professional physician, considering symptom duration (at least 2 weeks)
  • If you have suicidal ideation or behaviors, please immediately call a psychological crisis intervention hotline or go to the hospital
  • This assessment result is for reference only and cannot replace professional medical diagnosis

7. Core Symptoms of Depression

Understanding the core symptoms of depression before taking the self-assessment can help you complete the test more accurately:

  • Persistent low mood, loss of interest in anything, anhedonia
  • Significant decrease in energy, easy fatigue, feeling exhausted after minimal activity
  • Sleep disturbances: may experience insomnia (difficulty falling asleep, early awakening) or hypersomnia
  • Appetite and weight changes: decreased appetite, weight loss, or increased appetite, weight gain
  • Cognitive dysfunction: difficulty concentrating, slowed thinking, memory decline
  • Self-blame and guilt, excessive guilt, feelings of hopelessness about the future
  • Possible suicidal ideation or suicidal behavior

If you consistently experience one or more of the above symptoms in your daily life, it is recommended to undergo assessment through professional tools and seek professional help promptly. Early detection and early intervention are key to improving the prognosis of depression.