The Hamilton Depression Rating Scale, abbreviated HAM-D or HDRS, is a clinician-rated measure of depression severity first published by Max Hamilton in 1960. Unlike the PHQ-9, which you fill out yourself, the HAM-D is scored by a trained clinician during a structured interview. The most common version has 17 items covering depressed mood, guilt, suicidal thoughts, early, middle and late insomnia, work and activities, slowed movement, agitation, anxiety, physical symptoms, loss of interest in sex, hypochondria, weight loss and insight. Some items score 0 to 2 and others 0 to 4, giving a total from 0 to 52.
General guidance treats 0 to 7 as normal or in remission, 8 to 16 as mild, 17 to 23 as moderate, and 24 or above as severe. The HAM-D has been the primary outcome measure in most antidepressant trials for six decades, so when you read that a medication or TMS protocol produced a certain remission rate, it was often defined as a HAM-D of 7 or less. The scale gives heavy weight to sleep and physical symptoms, which some researchers consider a weakness, and the MADRS was developed partly to correct that. In routine care, Stedfast Psychiatry relies mostly on self-report scales such as the PHQ-9, but you may encounter the HAM-D during TMS or Spravato evaluations because insurance reviewers and clinical protocols frequently reference it.