The HAM-D is a depression scale a clinician scores from an interview, usually about the past week. Its common 17-item version, the HAM-D17, totals 0 to 52 and measures how severe depression is and how it changes with treatment. See what each score means, how response and remission are judged, and record the result with the free template. The scale itself comes from the original paper or the version your service uses.
HAM-D result template
FreeHAMILTON DEPRESSION RATING Rating date: [Date] Patient: [Name or record number, age] RATING DETAILS HAM-D version: [17-item, 21-item, or 24-item] Interview guide: [GRID-HAMD, SIGH-D, another structured guide, or unstructured] Interviewer: [Name, role, and training on this version] Interview format: [In person or video; minutes taken; interpreter if used] Rating period: [Past 7 days, or the period your protocol sets] Purpose: [Baseline before treatment, follow-up, end of a treatment course, or study visit] SEVERITY TODAY HAM-D17 total: [0 to 52] Severity band: [Normal 0 to 7, mild 8 to 13, moderate 14 to 18, severe 19 to 22, or very severe 23 or more; name another set if your service uses one] Extra items in longer versions: [Their scores, kept apart from the 17-item total, or not used] AGAINST BASELINE Baseline HAM-D17: [Date, total, and what treatment started then] Change: [Points and percent since baseline] Response status: [Response at a fall of 50% or more, remission at 7 or less, improving, unchanged, or worse] ITEMS TO NOTE Suicide item: [Score; if above 0, the same-day risk assessment and what it found] Areas carrying the score: [Symptom areas rated near the top of their range, such as low mood, guilt, sleep, or anxiety] Things that may inflate it: [Physical illness, medicine side effects, or recent events that raise the physical or anxiety items] Not counted by the scale: [Oversleeping, eating more, or weight gain, if present] PLAN Treatment decision: [Continue, raise the dose, switch, add therapy or a second medicine, refer, or consider ECT or TMS] Next HAM-D: [Date or weeks from now; same version, guide, and interviewer where possible] Rated by: [Name, credentials]
Use it for
Pick one version and one interview guide, and keep them for the whole course of treatment or the whole study.
Avoid: Switching versions or guides partway through treatment. A change in method can look like a change in the patient.
The clinician asks about the past week and rates each symptom area from what the patient says and what they see. A structured interview takes about 20 to 30 minutes.
Avoid: Rating from memory after the visit or from the chart alone. Score each item during or straight after the interview.
Nine items score 0 to 4 and eight score 0 to 2. Add the 17 for a total from 0 to 52.
Avoid: Adding the extra items of a longer version into the total and then reading it against the 17-item bands.
The band shows how severe the depression is now; the change from baseline shows whether treatment is working.
Avoid: Using the total to make the diagnosis. The diagnosis comes from the full assessment.
One item rates suicidal thoughts and acts. Any score above 0 needs a risk assessment before the patient leaves.
Avoid: Reading a falling total as falling risk. The suicide item can rise while the total drops.
Each one follows the recording template. Use them to judge how much to write.
Outpatient psychiatry clinic, medication review in person
HAM-D17 with the GRID-HAMD guide, rating the past 7 days. Rated by the treating psychiatrist, who also did the baseline; in person, 25 minutes. Follow-up rating.
HAM-D17 total 17: moderate. No longer versions used.
Baseline 22, severe, on September 28, when escitalopram 10 mg was started. Down 5 points, 23%: some improvement, well short of a response.
47-year-old man, third episode of depression. Suicide item 0 today; it was 1 at baseline, with passive thoughts and no plan or intent on assessment then. Sleep has improved most: the three sleep items fell from 5 to 2 of 6. Low mood and work and interests still rated 3 of 4, guilt 2. Nausea in the first two weeks has settled, so the physical items aren’t raised by side effects. No oversleeping or weight gain.
Escitalopram raised to 20 mg. Referred for weekly behavioral activation therapy. Next HAM-D17 in 4 weeks with the same guide and rater; if the fall is still under 50% at 10 weeks, discuss switching or adding a second medicine. Crisis plan and 988 reviewed with him.
Outpatient mental health clinic, video review 8 months after starting treatment
HAM-D17 with the SIGH-D guide, rating the past 7 days. Rated by the psychiatric nurse practitioner who did her baseline; by video, 20 minutes. Maintenance review.
HAM-D17 total 6: normal range.
Baseline 24, very severe, on March 10, when sertraline and weekly cognitive behavioral therapy began. Down 18 points, 75%. She scored 7 in August, so this is her second rating in a row at 7 or less: remission holding.
35-year-old woman, first episode. Suicide item 0, as at every rating since April. The 6 points left: low mood, work and interests, anxious thoughts, energy and aches, waking in the night, and sexual interest, 1 each. The sexual interest point began with sertraline and is more likely a side effect than depression. No oversleeping or weight gain.
She asked about stopping sertraline. Agreed to continue 100 mg for at least 6 more months, then plan a slow taper together; therapy moves to monthly sessions. Options for the sexual side effect discussed; she prefers to wait. Her early warning signs written down: poor sleep and pulling back from friends. Next HAM-D17 in 3 months, sooner if the signs return.
A 24-item total of 20 isn’t a 17-item total of 20. Record the version every time, and compare like with like.
Free-form questions give scores that vary from rater to rater. A structured guide and the same interviewer make the trend worth trusting.
Oversleeping, eating more, and weight gain add no points. A low total can sit alongside clear depression with these features, so ask about them.
A falling total can hide a rising suicide item. Read it at every rating and act on any score above 0.
It takes 20 minutes or more and a trained rater, and it wasn’t built to find new cases. Screen with a self-report tool such as the PHQ-9, and keep the HAM-D for measuring severity.
Vero Scribe records the HAM-D result in your template from the visit, with the patient’s consent, or from your dictation: the version, the total and band, the change from baseline, the suicide item, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
A trained clinician interviews the patient about the past week and rates each of the 17 items: nine from 0 to 4 and eight from 0 to 2. Adding them gives a total from 0 to 52. Use the anchors on your version’s form, ideally with a structured interview guide such as the GRID-HAMD or the SIGH-D.
In one widely used set, 0 to 7 is normal or remission, 8 to 13 mild, 14 to 18 moderate, 19 to 22 severe, and 23 or more very severe. Other sets exist: a 2013 study proposed 8 to 16 mild, 17 to 23 moderate, and 24 or more severe. Whichever you use, name it in the record.
Response is usually a fall of 50% or more from the baseline total. Remission is a 17-item total of 7 or less. A patient can respond without reaching remission: a fall from 26 to 12 is a response, but 12 is still mild depression.
The 17-item version is the standard severity score. The 21-item version adds four items that describe the type of depression, such as mood that varies through the day, and they’re usually left out of the total. The 24-item version adds helplessness, hopelessness, and worthlessness. Totals from different versions can’t be compared.
The PHQ-9 is a self-report questionnaire on the nine symptoms of major depression, scored 0 to 27, and it’s used to screen and track in everyday care. The HAM-D is rated by a clinician from an interview, scores 0 to 52, and gives more weight to anxiety and physical symptoms; it’s mainly a research and specialty measure. The MADRS, another clinician-rated scale, has 10 items with fewer physical ones.
A clinician trained in the scale: usually a psychiatrist, psychologist, psychiatric nurse or nurse practitioner, or a trained research rater. Practice on recorded interviews and checking agreement with other raters matter more than profession.
The 1960 scale is widely described as in the public domain, and Hamilton’s original paper is free to read on PubMed Central. Structured guides and versions published in books or software can carry their own terms, so use the version your service or study has adopted and check its terms. The recording template on this page is free to copy or download.
Nine questions on the last two weeks: depression screening and severity, scored 0 to 27.
Two questions on interest and mood: a quick first screen for depression, scored 0 to 6.
Seven questions on worry and tension: anxiety screening and severity, scored 0 to 21.
Up to six questions on suicidal thoughts and behavior; the highest yes sets low, moderate, or high risk.
Twenty items on the past month: PTSD screening and symptom tracking, scored 0 to 80.
Follow-up visits with symptoms, medicines, risk, and the plan.
When the suicide item is above 0: ideation, intent, means, and your risk judgment.
Evaluations and medication follow-ups documented from the visit.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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