Outcome MeasureDepression

HAM-D

Hamilton Depression Rating Scale

80 Papers in Blossom

About This Instrument

The Hamilton Depression Rating Scale (HAM-D or HDRS) is a clinician-administered assessment developed by Max Hamilton in 1960, making it one of the earliest and most widely used instruments for measuring depression severity. The most common version (HAM-D-17) contains 17 items covering depressed mood, guilt, suicidality, insomnia, work and activities, psychomotor retardation or agitation, anxiety, somatic symptoms, loss of insight, and weight loss. Items are scored on either 3-point (0–2) or 5-point (0–4) scales. The HAM-D has been used extensively in psychedelic depression research, including Imperial College London’s psilocybin trials for treatment-resistant depression. While criticized for heavy weighting of somatic and sleep symptoms (which can inflate scores in medically ill populations), it remains a regulatory standard and enables comparison across decades of antidepressant research.

Clinical Thresholds

052
Normal
Score 0–7
Mild
Score 8–13
Moderate
Score 14–18
Severe
Score 19–22
Very severe
Score 23–52

Outcome Data Across Studies

Reported results for HAM-D across 46 studies with quantitative data.

Outcome data across 213 study arm–timepoint observations
SD
MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder
2008Secondary
MDMA 50mg(experimental)0341.0——
MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder
2008Secondary
MDMA 50mg(experimental)7339.0——
MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder
2008Secondary
MDMA 75mg(experimental)0160.0——
MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder
2008Secondary
MDMA 75mg(experimental)7119.0——
MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder
2008Secondary
Placebo(placebo)0235.5——
MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder
2008Secondary
Placebo(placebo)7228.0——
Single Ketamine Infusion and Neurocognitive Performance in Bipolar Depression
2014Secondary
Ketamine infusion(experimental)01824.05.0—
Single Ketamine Infusion and Neurocognitive Performance in Bipolar Depression
2014Secondary
Ketamine infusion(experimental)31813.06.0—
Single Ketamine Infusion and Neurocognitive Performance in Bipolar Depression
2014Secondary
Ketamine infusion(experimental)71812.07.0—
Nitrous Oxide for Treatment-Resistant Major Depression: a Proof-of-Concept Trial
2015Primary
Nitrous oxide vs placebo(experimental)02023.53.1—

Papers Using HAM-D

Open Accessindividual

GH001 vs Placebo in Patients With Treatment-Resistant Depression A Randomized Clinical Trial

This randomised, double-blind, placebo-controlled Phase IIb trial (n=81) found that a single-day inhaled synthetic mebufotenin treatment (GH001; 5-MeO-DMT) reduced depression symptoms more than placebo in adults with treatment-resistant depression, with remission in over half of those treated. No severe or serious adverse events were reported during the placebo-controlled period.

Published
Journal
JAMA Psychiatry
Authors
Cubała, W. J., Bajbouj, M., Bauer, M., Baune, B. T., Cardoner, N., Devlin, F., Doolin, K., Dueñas Herrero, R. M., Elices, M., Feeney, A., Gałuszko-Węgielnik, M., Jakuszkowiak-Wojten, K., Janů, L., Kelly, J. R., Ledden, K., Maclsaac, R., Madero, S., McInerney, S. J., Montejo, A. L., Nawka, A., Páleníček, T., Pérez Solà, V., Ramaekers, J. G., Reif, A., Ritter, P., Ryan, F., Svendsen, C. B., Sweeney, C., Terwey, T. H., Trivedi, M. H., Valcheva, V., Vieta, E., Thase, M. E.
Open Accessindividual

Efficacy and Safety of Psilocybin in Treatment-Resistant Major Depression: The EPISODE Randomized Clinical Trial

In this triple‑blind, active placebo‑controlled randomised trial (n=144) of adults with treatment‑resistant depression, two 25 mg doses of psilocybin plus adjunct psychotherapy produced clinically meaningful reductions in depressive symptoms on exploratory secondary measures but did not significantly improve the pre‑second‑dose HAMD17 response rate versus nicotinamide.

Published
Journal
JAMA Psychiatry
Authors
Mertens, L. J., Koslowski, M., Betzler, F., Brand, M., Evens, R., Kärtner, L., Jungaberle, A., Jungaberle, H., Majić, T., Schmitz, C. N., Ströhle, A., Scharf, D., Spangemacher, M., Wolff, M., Assadi, Z., Bahri, S., Becher, L., Färber, L. V., Kirchen, N., Kulakova, E., Kunz, L., Meijer, A., Rohrmoser, B., Wellek, S., Berger, M. M., Gründer, G.
Paywallindividual

Long-term outcomes of single-dose psilocybin for U.S. military Veterans with severe treatment-resistant depression - 12-month data from an open-label pilot study

This open-label follow-up study (n=10) of Veterans with severe treatment-resistant depression (TRD) found that a single dose of psilocybin (25mg) significantly reduced depression for up to 12 months, though effects began to wane after 6 months, with 40% maintaining response and 30% maintaining remission at the 12-month follow-up.

Published
Journal
Journal of Affective Disorders
Authors
Ellis, S., Bostian, C., Donnelly, A., Feng, W., Eisen, K., Lean, M., Conlan, E., Ostacher, M., Aaronson, S., Suppes, T.
Open Accessindividual

Perturbing whole-brain models of brain hierarchy: An application for depression following pharmacological treatment

Using whole‑brain models guided by the thermodynamics of mind, the authors perturb model parameters to estimate brain hierarchy and quantify state susceptibility and drivability in major depressive disorder before and after psilocybin or escitalopram treatment. They find escitalopram reduces susceptibility while psilocybin increases it, yet both treatments promote transitions to healthier states, demonstrating the models' potential to inform in‑silico neurostimulation protocols for neuropsychiatric disorders.

Published
Journal
Annals of the New York Academy of Sciences
Authors
Socoró-Garrigosa, M., Sanz Perl, Y., Kringelbach, M. L., Erritzoe, D., Nutt, D. J., Carhart-Harris, R. L., Vohryzek, J., Deco, G.
Open Accessindividual

Oral esketamine for patients with severe treatment-resistant depression: Effectiveness, safety, and tolerability of a six-week open-label treatment program

In a naturalistic open‑label study of 185 adults with severe treatment‑resistant depression, twice‑weekly individually titrated oral esketamine for six weeks significantly reduced depressive symptoms (HDRS‑17 mean 21.2→15.8, p<0.001) with MCID 47.1%, response 26.8% and remission 15.6%, and a low dropout rate (7.6%). Treatment was generally well tolerated with frequent but manageable side effects and no significant urinary or cognitive adverse effects, suggesting oral esketamine is a safe, patient‑friendly option with effectiveness comparable to other administration routes.

Published
Journal
Journal of Psychopharmacology
Authors
Veraart, J. K. E., Smith-Apeldoorn, S. Y., van der Meij, A., Spijker, J., Schoevers, R. A., Kamphuis, J.
Open Accessindividual

Single-Dose Psilocybin for Depression With Severe Treatment Resistance: An Open-Label Trial

This open-label trial (n=12) conducted at Sheppard Pratt Hospital finds that psilocybin (25mg) significantly decreases depressive symptoms in patients with severe treatment-resistant depression (TRD) at 3 weeks (MADRS −15.8) and 12 weeks (MADRS −17.2) post-treatment. Exploratory analyses suggest the Oceanic Boundlessness dimension correlates with antidepressant responses, while patients with comorbid PTSD show reduced antidepressant effects.

Published
Journal
American Journal of Psychiatry
Authors
Aaronson, S. T., Van Der Vaart, A., Miller, T., Lapratt, J., Swartz, K., Shoultz, A., Lauterbach, M., Suppes, T., Sackeim, H. A.

Quick Facts

Full Name
Hamilton Depression Rating Scale
Domain
Depression
Papers Indexed
80
Score Range
0–52
Interpretation
Lower = better
Unit
points
Reference
Visit
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