The Hamilton Rating Scale for Depression (HRSD), also known as the Hamilton Depression Rating Scale (HDRS), is a widely used assessment tool designed to measure the severity of depressive symptoms in individuals diagnosed with depression. Developed by psychiatrist Max Hamilton in the late 1950s, the HRSD aims to objectively evaluate the presence and intensity of depressive symptoms, aiding in the diagnosis and monitoring of depression.

The HRSD consists of several subscales, or subcategories, which focus on different aspects of depression. These include:

• Depressed Mood: Assesses the individual’s subjective feelings of sadness, hopelessness, and despair.
• Feelings of Guilt: Measures the presence and extent of guilt or self-blame experienced by the person.
• Suicidal Ideation: Evaluates the intensity of suicidal thoughts or behaviors.
• Insomnia: Assesses the severity of sleep disturbances in terms of falling asleep, staying asleep, or early morning awakening.
• Anxiety: Measures the level of general anxiety experienced by the individual.
• Somatic Complaints: Evaluates physical symptoms associated with depression, such as fatigue, appetite changes, and body aches.

Each item on the HRSD is rated on a scale from 0 to 4 or 0 to 6, depending on the particular subscale. Higher scores indicate greater severity of symptoms. The sum of all item scores provides an overall measure of depression severity. Interpretation of the total score is as follows:

• 0-7: No depression present
• 8-13: Mild depression
• 14-18: Moderate depression
• 19-22: Severe depression
• ≥ 23: Very severe depression

It is important to note that the HRSD is just one tool among many in assessing depression and should be used in conjunction with other diagnostic measures. It relies heavily on the clinician’s interpretation and can sometimes be influenced by external factors. Additionally, scores may vary based on cultural, age-related, and gender-related factors, requiring careful interpretation in diverse populations.