The Hamilton Depression Rating Scale, abbreviated as HDRS, HRSD or HAM-D, measures depression in people before, during and after treatment. A depression rating scale is a psychiatric measurement instrument that has descriptive words and phrases that indicate the severity of depression over a period of time. When used, an observer can make judgments and rate a person at a specific scale level with respect to the characteristics identified. Instead of being used to diagnose depression, a depression assessment scale can be used to assign a score to a person’s behavior, where that score can be used to determine if that person should be further evaluated for the diagnosis of a depressive disorder. These scales serve as depression screening tools, including brief instruments like the two item depression screener, which are used for early detection.
For this purpose, several rating scales are used. The BDI is considered to be the most widely considered and used self-report rating scale for depression. The Beck Depression Inventory II (BDI-II) is a revised version that aligns with DSM criteria and assesses depression severity across a range of symptoms. Aaron Beck created the Beck Depression Inventory scales in 1961 to assess change in patients undergoing psychoanalysis. Focuses on the patient’s thoughts and experiences. The BDI and similar self-report scales are self report measures designed to assess the severity of depressive symptoms, including specific symptoms such as affective symptoms like depressed mood.
Over time, modifications were made, creating a version more consistent with the cognitive-behavioral theory of BDI-II. The questionnaire consisted of items on the examination of the percentage of patients clinically using depression rating scales, the reasons for not using them, the degree of satisfaction, the perceived concordance rate between the outcome of the depression rating scales and the clinical interview with the doctor in the evaluation of patients with depressive symptoms. If it is below 50%, they were asked to directly describe why they do not use scales in clinical practice. In other words, the objectives of the present study were to investigate the frequency and reason for not using, the degree of perceived satisfaction with the currently available depression rating scales, and the perceived concordance between subjective clinical interviews and depressive measures.
When researchers use depression rating scales, they can make judgments and rate a patient based on a specific scale, taking into account the characteristics observed. These tools are used in various clinical settings and are administered by healthcare professionals to support clinical diagnosis and monitor treatment progress. The Geriatric Depression Scale (GDS) was developed specifically for use in geriatric populations, originally as a 30-item scale. Its preliminary report established its validity, and subsequent psychiatric research and systematic reviews have confirmed its reliability. At the macroanalytical level, it is appropriate to discuss depression rating scales such as HAM-D in comparison with a system for diagnosing mental disorders such as the Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV) 3, while at the microanalytical level a direct comparison between Dr. The Gestalt and Dr.
Scales are relevant. Therefore, this study aimed to investigate the current use of measures of depression in the clinical setting in Korea. The clinical use of depression rating scales was more frequent in psychologists than in psychiatrists. Among the domestic and foreign depression rating scales, including those standardized and non-standardized in Korea, it was noted that the types of depression rating scales currently used in the field of clinical practice are not diverse. The Children's Depression Inventory is a self rating depression scale for younger populations, while postpartum depression scales are not the focus of this article.
This depression rating scale includes a 27-item screening questionnaire and a follow-up clinical interview designed to facilitate the diagnosis of common mental disorders in primary care. These scales help identify mild depression, moderate depression, and moderately severe cases, and a positive screen indicates the need for further evaluation or a treatment plan. A working committee composed of four psychiatrists, two clinical psychologists and a medical statistician was organized to draft the questionnaire after reviewing the depression assessment scales used in Korea. We hope that this research will be basic research to invent the Korean standardized diagnosis and rating scales for depression in the future. The use of a self-assessment version of HAM-D has focused on translation procedures when preparing non-English versions of the scale.
Designed by psychiatrist Max Hamilton in 1960, the Hamilton Depression Rating Scale is one of the two most used among those completed by researchers evaluating the effects of pharmacotherapy. These tools are validated for use in the adult population as well as in children and adolescents.
Epidemiologic Studies and Depression Scales
Epidemiologic studies are fundamental in uncovering the prevalence, risk factors, and impact of major depressive disorder and other mental disorders across diverse populations. By systematically collecting data on depressive symptoms, these studies help healthcare professionals and researchers understand how depression affects the general population, different age groups, and specific at-risk communities. Central to this research are depression assessment instruments—tools that allow for the accurate measurement and monitoring of depression severity and symptomatology.
Among the most widely used depression screening tools in epidemiologic research are the Patient Health Questionnaire (PHQ), Beck Depression Inventory (BDI), and the Center for Epidemiologic Studies Depression Scale (CES-D). These depression scales are designed to assess depressive symptoms over a defined period, such as the past week, and are validated for use in both clinical and general population settings. The PHQ-9, for example, is a brief depression severity measure that is especially popular in primary care settings and primary care clinics, enabling healthcare professionals to quickly screen for mild, moderate, or severe depression and determine the need for further evaluation or a more comprehensive assessment.
For older adults, the Geriatric Depression Scale (GDS) and its variants, such as the geriatric depression screening scale, are tailored to assess depression severity while accounting for age-related factors and somatic aspects. In contrast, the Children’s Depression Inventory (CDI) is a specialized screening tool for identifying depressive symptoms in children and adolescents, ensuring that depression screening is sensitive to developmental differences across age groups.
The Hamilton Depression Rating Scale (HAM-D) remains a gold standard in clinical research for measuring depression severity, particularly in studies evaluating treatment outcomes and the effectiveness of interventions. These rating scales, along with self-report measures like the BDI-II and the CES-D scale, provide valuable data on the core symptoms of depression, including depressed mood, cognitive dysfunction, somatic symptoms, and even suicidal ideation. This information is crucial for developing targeted treatment plans and monitoring patient health over time.
Epidemiologic studies also utilize additional tools to assess the broader impact of depression on health-related quality of life. Instruments such as the EQ-5D and the Social Problem-Solving Inventory-Revised (SPSI-R) help capture the functional and social consequences of depressive symptomatology, offering a more holistic view of patient well-being.
By employing a range of depression screening tools and rating scales, epidemiologic studies contribute to a deeper understanding of depression’s diagnostic criteria, risk factors, and treatment outcomes. These insights inform clinical practice, guide public health strategies, and ultimately support better mental health for individuals and communities. Whether in primary care, mental health settings, or clinical research, the careful selection and use of depression assessment instruments are essential for accurately measuring depression, improving diagnostic accuracy, and enhancing patient care.
