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Hamilton Anxiety Rating Scale

HAM-A

The Hamilton Anxiety Rating Scale is the oldest anxiety rating scale still in general use, and it is the one most supplement trials report. When an evidence page on this site says a trial moved anxiety by four points, this is usually the scale those points were on.

Each of the fourteen items is rated from 0, not present, to 4, very severe, over the past week. The total runs from 0 to 56. Items 1 to 6 and item 14 make up the psychic subscale; items 7 to 13 make up the somatic one.

Hamilton wrote it for an interviewer to fill in, and item 14 is rated from what that interviewer sees rather than from what the patient reports. Filling it in about yourself is a useful way to read a trial, not a rated measurement of your own anxiety.

0 of 14 answered0%

Psychic anxiety

Items 1 to 6. Rate each over the past week.

1.Anxious mood

Worries, anticipation of the worst, fearful anticipation, irritability.

2.Tension

Feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax.

3.Fears

Of the dark, of strangers, of being left alone, of animals, of traffic, of crowds.

4.Insomnia

Difficulty falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.

5.Intellectual

Difficulty concentrating, poor memory.

6.Depressed mood

Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.

Somatic anxiety

Items 7 to 13. The physical symptoms, rated the same way.

7.Somatic symptoms (muscular)

Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.

8.Somatic symptoms (sensory)

Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.

9.Cardiovascular symptoms

Tachycardia, palpitations, pain in the chest, throbbing of vessels, fainting feelings, missing a beat.

10.Respiratory symptoms

Pressure or constriction in the chest, choking feelings, sighing, breathlessness.

11.Gastrointestinal symptoms

Difficulty swallowing, wind, abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, rumbling, looseness of the bowels, loss of weight, constipation.

12.Genitourinary symptoms

Frequency and urgency of urination, absent or heavy periods, loss of libido, premature ejaculation, impotence.

13.Autonomic symptoms

Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.

At interview

Item 14. Rated from what the interviewer observes, not from what is reported.

14.Behaviour at interview

Fidgeting, restlessness or pacing, tremor of the hands, furrowed brow, strained face, sighing or rapid breathing, facial pallor, swallowing, belching, brisk tendon jerks, dilated pupils, sweating, eyelid twitching.

14 questions are still blank. The score appears here once every one has an answer — a partial total is a smaller number for the same person, so this page does not show one.

Where this comes from

Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50-55.

Read it on PubMed

Public domain. Hamilton's 1959 item list carries no licence.

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