A clinician uses the Hamilton Rating Scale for Depression (HAM-D). Which of the following is the CORRECT interpretation of the HAM-D-17?
- A It is a self-report questionnaire; score ≥24 indicates mild depression
- B It is a 21-item scale that exclusively measures vegetative symptoms of depression
- C It is clinician-administered; scores: 0–7 normal, 8–13 mild, 14–18 moderate, 19–22 severe, ≥23 very severe ✓
- D It measures both depressive and anxiety symptoms equally, with a validated cut-off of 18 for remission
Correct answer: C. It is clinician-administered; scores: 0–7 normal, 8–13 mild, 14–18 moderate, 19–22 severe, ≥23 very severe
Explanation
The Hamilton Rating Scale for Depression (HAM-D or HRSD) is a clinician-administered (not self-report) scale. The 17-item version (HAM-D-17) is the most widely used. Severity ranges: 0–7 = no depression/normal; 8–13 = mild; 14–18 = moderate; 19–22 = severe; ≥23 = very severe. Remission in clinical trials is usually defined as HAM-D-17 ≤7. It emphasises vegetative and somatic symptoms and was developed for assessment of treatment response in already-diagnosed depression, not as a diagnostic tool.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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