Skip to main content

Hamilton Scale for Depression

Hamilton Scale for Depression


HAMD or HDRS was developed by Max Hamilton in 1960

● Clinician-rated, unlike Beck scales which are self-rated

● It starts with an item on depression and ends with one on obsessive-compulsive symptoms.

● The most widely used clinician-administered depression assessment scale.

● The original version contains 17 items (HDRS17) pertaining to symptoms of depression experienced over the past week. The HDRS was originally developed for hospital inpatients, thus the emphasis on melancholic and physical symptoms of depression. A later 21-item version (HDRS21) included 4 items intended to subtype the depression, but which are sometimes, incorrectly, used to rate severity. ● Only the first 17 should be used to measure the severity

● A limitation of the HDRS is that atypical symptoms of depression (e.g., hypersomnia, hyperphagia) are not assessed.

Scoring 
● The method for scoring varies by version. For the HDRS17, a score of 0–7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher (indicating at least moderate severity) is usually required for entry into a clinical trial. Scores of 8—14— 19—23 or above respectively indicate mild, moderate, severe, and very severe depression.

Interpretation of HAM-D scores:  

NORMAL 0—7

MILD 8—13

MODERATE 4—18

SEVERE 19—22

VERY SEVERE 23 and above


Comments

Popular posts from this blog

ADVOKATE: A Tool for Assessment of Eyewitness Evidence

ADVOCATE: A Tool for Assessment of Eyewitness Evidence It is a tool designed to assess the eyewitness evidence that how much it is reliable. It requires the user to respond to several statements/questions. Forensic psychologist, police or investigative officer can do it. The mnemonic ADVOKATE stands for: A = amount of time under observation (event and act) D = distance from suspect V = visibility (night-day, lighting) O = obstruction to the view of the witness K = known or seen before when and where (suspect) A = any special reason for remembering the subject T = time-lapse (how long has it been since witness saw suspect) E = error or material discrepancy between the description given first or any subsequent accounts by a witness.  Working with suspects (college.police.uk)

Diagnostic test for catatonia, the lorazepam challenge test

Benzodiazepines are the mainstay of the treatment of catatonia and are also helpful as a diagnostic probe. A positive Lorazepam Challenge Test validates the diagnosis of catatonia. After we examine the patient for signs of catatonia, 1 or 2 mg of lorazepam is administered intravenously. After 5 minutes, the patient is re-examined. If there has been no change, a second dose is given, and the patient is again reassessed (46, 78). A positive response is a marked reduction (e.g., at least 50%) of catatonic signs and symptoms, as measured with a standardized rating scale. Favorable responses usually occur within 10 min (46). If lorazepam is given intramuscularly or per os, the interval for the second dose should be longer: 15′ and 30′, respectively. Many clinicians will share the experience that a “lorazepam test” not only confirms the diagnosis of catatonia but that it also makes the underlying psychopathology apparent “by permitting mute patients to speak” (79). Analogous to the lorazepa

Classification of Depression According to the ICD-10

A first depressive episode, duration at least15 days →depressive episode (F32)  A first depressive episode, severe and rapid onset, duration less than 15 days →still depressive episode (F32) A depressive episode can be mild (2 core symptoms, 2 other symptoms from the list) (32.0) moderate (2 core symptoms, 3 or preferably 4 other symptoms) (32.1) Severe (3 core symptoms, 4 other symptoms) without psychotic symptoms (32.2) (no delusion, hallucination or stupor) Severe with psychotic symptoms (above plus either delusions, hallucinations or stupor) (F32.3) Delusions can be mood-congruent or incongruent (neutral delusions e.g. delusions of reference are considered mood incongruent. None of them count towards schizoaffective disorder unless one of the first-rank)  A mild and moderate depressive episode can be  with somatic syndrome (four or more somatic symptoms, or three very severe somatic symptoms) without somatic syndrome (three or less somatic symptoms, not severe)  A severe depressi