HAMILTON Patient Name: ____________________________ 

RATING SCALE Rater Name: ____________________________ 

FOR DEPRESSION Date: ____________________________ 

 

Activity Score 

 

Depressed mood _______ 
Sad, hopeless, helpless, worthless 
0 = Absent 
1 = Gloomy attitude, pessimism, hopelessness 
2 = Occasional weeping 
3 = Frequent weeping 
4 = Patient reports highlight these feelings states in his/her spontaneous verbal and 
non-verbal communication. 

 
Feelings of guilt _______ 
0 = Absent 
1 = Self-reproach, feels he/she has let people down 
2 = Ideas of guilt or rumination over past errors or sinful deeds 
3 = Present illness is punishment 
4 = Hears accusatory or denunciatory voices and/or experiences threatening visual 
hallucinations. Delusions of guilt. 

 

Suicide _______ 
0 = Absent 
1 = Feels life is not worth living 
2 = Wishes he/she were dead, or any thoughts of possible death to self 
3 = Suicide, ideas or half-hearted attempt 
4 = Attempts at suicide (any serious attempt rates 4) 

 

Insomnia, early _______ 
0 = No difficulty falling asleep 
1 = Complaints of occasional difficulty in falling asleep i.e. more than half-hour 
2 = Complaints of nightly difficulty falling asleep 

 

Insomnia, middle _______ 
0 = No difficulty 
1 = Patient complains of being restless and disturbed during the night 
2 = Walking during the night – any getting out of bed rates 2 (except voiding bladder) 

 

Insomnia, late _______ 
0 = No difficulty 
1 = Waking in the early hours of the morning but goes back to sleep 
2 = Unable to fall asleep again if he/she gets out of bed 

 

 

 Page 1 Score ______ 

 


 

 

 

Work and activities _______ 
0 = No difficulty 
1 = Thoughts and feelings of incapacity related to activities: work or hobbies 
2 = Loss of interest in activity – hobbies or work – either directly reported by patient or 
indirectly seen in listlessness, in decisions and vacillation (feels he/she has to push 
self to work or activities) 
3 = Decrease in actual time spent in activities or decrease in productivity. In hospital, 
rate 3 if patient does not spend at leas three hours a day in activities 
4 = Stopped working because of present illness. In hospital rate 4 if patient engages 
in no activities except supervised ward chores 

 

Retardation _______ 
Slowness of thought and speech; impaired ability to concentrate; decreased motor activity 
0 = Normal speech and thought 
1 = Slight retardation at interview 
2 = Obvious retardation at interview 
3 = Interview difficult 
4 = Interview impossible 

 

Agitation _______ 
0 = None 
1 = Fidgetiness 
2 = Playing with hands, hair, obvious restlessness 
3 = Moving about; can’t sit still 
4 = Hand wringing, nail biting, hair pulling, biting of lips, patient is on the run 

 

Anxiety, psychic _______ 
Demonstrated by: 

• subjective tension and irritability, loss of concentration 
• worrying about minor matters 
• apprehension 
• fears expressed without questioning 
• feelings of panic 
• feeling jumpy 


 0 = Absent 
1 = Mild 
2 = Moderate 
3 = Severe 
4 = Incapacitating 

 

 

 

 Page 2 Score ______ 

 


 

 

 

 

 

 

 

Anxiety, somatic _______ 
Physiological concomitants of anxiety such as: 

• gastrointestinal: dry mouth, wind, indigestion, diarrhea, cramps, belching 
• cardiovascular: palpations, headaches 
• respiratory: hyperventilation, sighing 
• urinary frequency 
• sweating 
• giddiness, blurred vision 
• tinnitus 


0 = Absent 
1 = Mild 
2 = Moderate 
3 = Severe 
4 = Incapacitating 

 

Somatic symptoms: gastrointestinal _______ 
0 = None 
1 = Loss of appetite but eating without encouragement 
2 = Difficulty eating without urging. Requests or requires laxatives or medication for GI symptoms 

 

Somatic symptoms: general _______ 
0 = None 
1 = Heaviness in limbs, back or head; backaches, headaches, muscle aches, loss of energy, fatigability 
2 = Any clear-cut symptom rates 2 

 

General Symptoms 
Symptoms such as: loss of libido, menstrual disturbances _______ 
0 = Absent 
1 = Mild 
2 = Severe 

 

Hypochondriasis _______ 
0 = Not present 
1 = Self-absorption (bodily) 
2 = Preoccupation with health 
3 = Strong conviction of some bodily illness 
4 = Hypochondrial delusions 

 
Page 3 Score ______ 


Loss of Weight 
Rate either ‘A’ or ‘B’: 

A When rating by history: 
0 = No weight loss 
1 = Probable weight loss associated with present illness 
2 = Definite (according to patient) weight loss 

B Actual weight changes (weekly): 
0 = Less than 1 lb (0.5 kg) weigh loss in one week 
1 = 1-2 lb (0.5 kg-1.0 kg) weight loss in week 
2 = Greater than 2 lb (1 kg) weight loss in week 
3 = Not assessed 

 

Insight _______ 
0 = Acknowledges being depressed and ill 
1 = Acknowledges illness but attributes cause to bad food, overwork, virus, need for rest, etc. 
2 = Denies being ill at all 

 

 

 Page 4 Score ______ 

 TOTAL Score ______ 

 

 

 

 

 

Reference 

Hamilton M. “Development of a rating scale for primary depressive illness.” 
Br J Soc Clin Psychol. 1967;6:278-296.