Before a psychotherapist is taken to eliminate depression, the suspected personality disorder must first be established. For this purpose, various methods of clinical diagnosis are often used. One of the most famous is the Hamilton scale, which is designed specifically for accurate assessment of the emotional state of the patient. Our site understands what it is and what is the practical significance.
Hamilton Depression Scale Review
Hamilton Depression Scale (The Hamilton Rating Scale for Depression HRSD, HDRS or Ham-D) is a tool for clinical diagnosis of patients with mental disorders of the dynamics of the disease. Created in the late 1950s by the British physician Max Hamilton, to quantify the condition of patients with depressive episodes before, during and after treatment. Hamilton's scale determines the effectiveness of drugs in the treatment of mental disorders.
In the classical scale there is from 17 to 24 points, so the variations of tests vary, but most often there is a version with the 21st point.
Filling is the responsibility of a psychotherapy specialist, because the survey technique is the most important stage of control and self-filling is undesirable. Patient survey on a scale - a structured interview, during which you can not put pressure on the patient, and the time frame for answers are allocated in free volume. The questions in the tests are most important and affect the quality of the study. Questions are combined: direct (yes / no) and open (detailed answer). Depending on the patient's answers - positive or negative, the sequence of questions may vary.
In case of doubts about the reliability of the results, the doctor has the right, by a similar method, to question the patient's relatives, comrades and colleagues, as well as medical staff involved in the treatment process. It is important to emphasize that conducting a test on the Hamilton scale for the second time cannot depend on the first attempt. It is absolutely impossible to compare the results obtained and rely on the answers of earlier studies.
The essence of the test
The Hamilton scale is filled by a psychiatrist who interviews a patient. For the test result to be reliable and to have a medical sense, questions for the patient are selected by a specialist and set in a certain way. The interview lasts about 20-30 minutes. Based on the patient's answers, the doctor places in the scale points that correspond to the intensity of the manifestation of the disorder: 0 - complete absence, 1 - rare expression, 2 - permanent manifestation, 3 - manifest non-verbally; 4 - bright and often manifestation.
Basic questions should indicate the manifestation of the following mental disorders:
1. Depression (includes depression, doom, helplessness and inferiority).
2. Guilt, depressive thoughts about their own inferiority.
3. Intentions to commit suicide or thoughts about death.
4. Early insomnia, problems at the stage of falling asleep.
5. The average type of restless sleep during the night.
6. Trouble with early awakening.
7. Reduced performance, loss of interest in the hobby.
8. Inhibition in thought and conversation, poor concentration of attention.
9. Agitation (active hand movements, restlessness, fingering, biting lips).
10. Mental anxiety (tension and irritability, constant feeling of fear).
11. Somatic manifestations (migraine, dry mouth, shortness of breath and increased sweating).
12. Gastrointestinal disorders, loss of appetite and the need for the use of laxatives.
13. Somatic features (heaviness in the vertebra, muscle pain of the limbs and general impotence).
14. Genital symptoms (sudden loss of libido and sexual desire, menstruation).
15. Hypochondria, excessive emphasis on health, complaints and requests for help.
16. Weight loss (based on anamnesis and when changes have a weekly cycle (from 0.5 to 1 kg).
17. Critical reaction to the fact of the disease (attitude to its own flaws).
18. Daily manifestations of anxiety, when the symptoms are more pronounced or, conversely, more weakly.
19. Depersonalization and derealization (a persistent attempt to change oneself or other people).
20. Paranoid signs (delusional perception of relationships, paranoia).
21. Obsessive and compulsive symptoms (obsessive thoughts).
The total number of points indicates the degree and dynamics of the depressive episode. It is considered on the first 17 points. 9 points out of 17 can be rated from 0 to 4, and the remaining 8 - from 0 to 2). The final questions of the Hamilton scale (from the 18th to the 21st) are necessary to describe the related symptoms of depression.
Results:
• up to 7 - standard indicators;
• from 8 to 13 - the initial form of the disorder;
• from 14 to 18 - moderate severity;
• from 19 to 22 - severe level of the disease;
• more than 23 - chronic stage (especially neglected).
The results obtained allow you to make a diagnosis and prescribe appropriate treatment measures.
Practical use
The Hamilton scale allows you to quickly and efficiently examine patients with suspected onset or development of depression, as well as to evaluate the effectiveness of antidepressants, based on the dynamics of the test. In conducting the test, the qualification of the doctor who will interview the patient plays an important role. Low qualifications will not only prevent you from getting the right results, but also can threaten the patient's condition to deteriorate due to the wrong medicines or a sharp negative dynamic of the disease.
The editors strongly recommend not to engage in “sofa diagnostics” of depression and turn to professionals! Remember, the sooner you diagnose and begin treatment for depression, the faster you will start living a full and happy life again!
Also recommends reading the following articles:
