What the HAM-D measures
Created by Max Hamilton, the HAM-D (or HDRS) is the most widely used clinician-administered depression assessment in the world, serving as the gold standard for antidepressant clinical trials (FDA). While originally designed for clinicians to rate patients during an interview, this adapted version translates the clinician rubrics into self-report diagnostic statements. Crucially, the HAM-D weights physical (somatic) symptoms of depression—such as insomnia, weight loss, and psychomotor retardation—just as heavily as subjective sadness.
The dimensions it assesses
- Mood & Cognition: Depressed mood, guilt, suicide ideation, loss of work interest.
- Insomnia: Early, middle, and late (terminal) insomnia.
- Somatic/Physical: Gastrointestinal distress, loss of libido, weight loss, somatic anxiety, general somatic symptoms (heavy limbs, backaches).
- Psychomotor: Agitation (restlessness) and Retardation (slowness of thought and speech).
Already have a HAM-D score from somewhere else? Look it up without retaking the questionnaire.
What your score means
(Theoretical Range: 0 to 52)
| Score | Interpretation | What it suggests |
|---|---|---|
| 0 – 7 | Normal | No evidence of clinical depression. |
| 8 – 13 | Mild Depression | Sub-clinical or mild depression. Psychotherapy (CBT/ACT) recommended. |
| 14 – 18 | Moderate Depression | Clinical MDD. Antidepressant pharmacotherapy combined with psychotherapy is standard of care. |
| 19 – 22 | Severe Depression | Severe MDD causing massive disruption to occupational and social functioning. |
| ≥ 23 | Very Severe Depression | Highest clinical urgency. Immediate psychiatric intervention required. Often accompanied by psychosis, total stupor, or severe suicidal risk. |
These ranges describe groups of people, not individuals. A score near a boundary is not meaningfully different from one just across it, and no range on this table is a diagnosis.
What to do with your result
- Critical Triage (Q3 Suicide): If Q3 scores ≥ 2 (Wishes they were dead or higher), trigger an immediate clinical safety protocol. Do not rely on the total score; the user must be routed to emergency psychiatric resources or hotlines immediately.
- Somatic Treatment Routing: The HAM-D heavily penalizes insomnia and weight loss. If the total score is driven largely by Q4-Q6 (Sleep) and Q16 (Weight), medical rule-outs (e.g., thyroid panels, sleep apnea testing) must be conducted before prescribing SSRIs.
- Tracking Drug Efficacy: A reduction in the HAM-D score by ≥ 50% from baseline is the global clinical definition of "Treatment Response," and a score ≤ 7 defines "Clinical Remission."
Common questions about the HAM-D
- What does the HAM-D measure?
- Measurement of the severity of Major Depressive Disorder (MDD) symptoms, with a heavy emphasis on somatic and physical manifestations.
- Can the HAM-D diagnose me?
- No. Depression Severity Interview (HAM-D) is a screening questionnaire, not a diagnostic tool. It can flag that something may need a closer look. It cannot tell you what is causing it. Grief, burnout, a thyroid problem, medication side effects, chronic pain and months of bad sleep are not among its questions, and any of them can move a score. Telling those apart is what a professional assessment is for.
- What is considered a high score on the HAM-D?
- Scores of ≥ 23 fall in the range described as "Very Severe Depression", while 0 – 7 is described as "Normal". Those labels describe bands of scores rather than people, and a score sitting one point either side of a boundary is not meaningfully different from one just across it.
- How long does the HAM-D take?
- 17 questions, which most people finish in 5 – 10 minutes. There is no time limit, and answering honestly matters more than answering quickly. The results page checks for patterns suggesting the questions were rushed.
- Is this HAM-D test really free?
- Yes. No account, no email address, no payment. Psychometrics Today is funded by donations rather than advertising, which is also what allows us to publish instruments whose authors permit free but non-commercial use.
- Are my answers stored or shared?
- No. Your answers are scored inside your browser and never sent to us. There is no database of responses, because we never receive any. Closing the tab erases them, which is why results cannot be recovered afterwards.
- How often should I retake the HAM-D?
- Most of these questionnaires ask about the past one to two weeks, so retaking sooner than that mostly measures the same period twice. Every two to four weeks is a reasonable rhythm if you are tracking change. A direction of travel over several weeks tells a doctor far more than any single score.
- Who created the HAM-D, and is this the real version?
- It was published by Max Hamilton (1960), published in J Neurol Neurosurg Psychiatry. Long-standing public domain status; reproduced freely in clinical literature. The items here are the published ones rather than a paraphrase, and the scoring follows the original rules. Both are documented on this page so they can be checked.
- How accurate is the HAM-D?
- Screening questionnaires are good at flagging that something merits attention and poor at establishing what it is. This one is sensitive to how you feel on the day you take it, and many instruments were validated on narrow populations whose cut-offs may not transfer cleanly to everyone. The references at the foot of this page are the primary sources.
Sources
Rights held by Max Hamilton (1960), published in J Neurol Neurosurg Psychiatry. Developed and validated by the researchers cited below.
- Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23(1), 56-62.
- Williams, J. B. (1988). A structured interview guide for the Hamilton Depression Rating Scale. Archives of General Psychiatry, 45(8), 742-747.
Licensing
Public domain. Long-standing public domain status; reproduced freely in clinical literature.
Designed as a clinician-administered interview. A self-report adaptation is not the validated instrument and must be labelled as such.