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The Hamilton Rating Scale for Depression (HRSD),^[1] also called the Hamilton Depression Rating Scale (HDRS), abbreviated HAM-D, is a multiple item questionnaire used to provide an indication of depression, and as a guide to evaluate recovery.^[2] Max Hamilton originally published the scale in 1960^[3] and revised it in 1966,^[4] 1967,^[5] 1969,^[6] and 1980.^[7] The questionnaire is designed for adults and is used to rate the severity of their depression by probing mood, feelings of guilt, suicide ideation, insomnia, agitation or retardation, anxiety, weight loss, and somatic symptoms.

Initially considered the "Gold Standard" for rating depression in clinical research, it is criticized as a test instrument for clinical practice in part because it places more emphasis on insomnia than on suicide ideas and gestures. An antidepressant may show statistical efficacy even when thoughts of suicide increase but sleep is improved.^[8] Hamilton maintained that his scale should not be used as a diagnostic instrument.^[9]

The original 1960 version contains 17 items to be rated (HRSD-17), but three other questions are not added to the total score and are used to provide additional clinical information. Each item on the questionnaire is scored on a 3 or 5 point scale, depending on the item, and the total score is compared to the corresponding descriptor. Assessment time is estimated at 20 minutes.

Scoring

A score of 0-7 is considered to be normal. Scores of 20 or higher indicate moderate, severe, or very severe depression, and are usually required for entry into a clinical trial.^[10] Questions 18-21 may be recorded to give further information about the depression (such as whether diurnal variation or paranoid symptoms are present), but are not part of the scale. A structured interview guide for the questionnaire is available.^[11]

Although Hamilton's original scale had 17 items, other versions were developed to include up to 29 items (HRSD-29).^[12]^[13]^[14]^[15]

Other Scales

Other scales include the Montgomery-Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), the Zung Self-Rating Depression Scale, the Wechsler Depression Rating Scale,^[16] the Raskin Depression Rating Scale,^[17] the Inventory of Depressive Symptomatology (IDS), the Quick Inventory of Depressive Symptomatology (QIDS),^[18] and other questionnaires.^[19]

Notes[edit]

^ "the ham-d scale". Retrieved 29 November 2012.
^ Hedlund JL, Viewig BW (1979) The Hamilton rating scale for depression: a comprehensive review. Journal of Operational Psychiatry 10:149-165
^ Hamilton, M (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry. 23: 56-62 doi:10.1136/jnnp.23.1.56 PMID 14399272
^ Hamilton M (1966) Assessment of change in psychiatric state by means of rating scales. Proceedings of the Royal Society of Medicine 59 (Suppl. 1): 10-13 PMID 5922401
^ Hamilton, M (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6: 278-96 PMID 6080235
^ Hamilton, M (1969) Standardised assessment and recording of depressive symptoms. Psychiatria, Neurologia, Neurochirurgia. 72:201-205 PMID 5792061
^ Hamilton, M (1980) Rating depressive patients. Journal of Clinical Psychiatry. 41: 21-24 PMID 7440521
^ Bagby RM, Ryder AG, Schuller DR, Marshall MB (2004). "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?". American Journal of Psychiatry 161 (12): 2163–77. doi:10.1176/appi.ajp.161.12.2163. PMID 15569884.
^ Berrios G E & Bulbena A (1990) The Hamilton Depression Scale and the Numerical Description of the Symptoms of Depression. In Bech P & Coppen A (ed) The Hamilton Scales, Heildeberg, Springer, pp80-92
^ HDRS-17: Hamilton Depression Rating Scale (HDRS) at University of Florida, College of Medicine. Additional Questions Retrieved December 12, 2011.
^ Williams JBW (1989) A structured interview guide for the Hamilton Depression Rating Scale. Archives of General Psychiatry 45: 742-747. PMID 3395203
^ HRSD-7: 7-ITEM HAMILTON RATING SCALE FOR DEPRESSION: HAMD-7 in Official website of CANMAT: Canadian Network for Mood and Anxiety Treatments Accessed June 30, 2008, and McIntyre R, Kennedy S, Bagby RM, Bakish DJ (2002) Assessing full remission. Journal of Psychiatry and Neuroscience 27: 235-239 PMID 12174732
^ HRSD-21: The Hamilton Rating Scale for Depression (to be administered by a health care professional) (presented as a service by GlaxoWellcome, February 1997) in UMass HealthNet: Consumer Health Resources for Massachusetts Residents: Official website of the Lamar Soutter Library, University of Massachusetts Medical School, Worcester, MA, 01655 USA. Retrieved June 27, 2008.
^ HRSD-24: Hamilton Depression Rating Scale - 24 item (to be completed by a trained clinician) in FOCUS ON ALZHEIMER'S DISEASE: MEDAFILE; Site constructed and maintained by J. Wesson Ashford, M.D., Ph.D., Stanford / VA Alzheimer's Center, Palo Alto VA Hospital, 3801 Miranda Way, Palo Alto, CA 94304 USA. Retrieved June 27, 2008.
^ HRSD-29: Williams JBW, Link MJ, Rosenthal NE, Terman M, Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders Version (SIGHSAD). New York Psychiatric Institute, New York, 1988
^ Wechsler H, Grosser GH, Busfield BL Jr (1963) The depression rating scale: a quantitative approach to the assessment of depressive symptomatology. Archives of General Psychiatry. 9: 334-343 PMID 14045262
^ Raskin A, Schulterbrandt J, Reatig N, McKeon JJ (1969) Replication of factors of psychopathology in interview, ward behavior and self-report ratings of hospitalized depressives. Journal of Nervous and Mental Diseases 148: 87-98 doi:10.1097/00005053-196901000-00010 PMID 5768895
^ Inventory of Depressive Symptomatology (IDS) & Quick Inventory of Depressive Symptomatology (QIDS) in IDS/QIDS: Instruments in English and Multiple Translations by the University of Pittsburgh Epidemiology Data Center, 2008. Retrieved June 27, 2008.
^ Psychiatric Rating Scales for Depression in www.neurotransmitter.net website by Shawn M. Thomas. Retrieved June 30, 2008.

External links[edit]

HRSD online calculator
The Hamilton Rating Scale for Depression PDF (49.0 KB)
Clinically Useful Psychiatric Scales: HAM-D (Hamilton Depression Rating Scale). Accessed March 6, 2009.
Hamilton Depression Rating Scale - Original scientific paper published in 1960 in Psychiatry out of Print website. Accessed June 27, 2008.
Commentary on the HRSD by Max Hamilton, July 10, 1981, in "This Week's Citation Classic", Current Contents 33: 325 (August 17, 1981), in website of Eugene Garfield, Ph.D.. Accessed June 27, 2008.
Side-by-side comparison of the MADRS and the HDRS-24 in "Description of the Hamilton Depression Rating Scale (HAMD) and the Montgomery-Asberg Depression Rating Scale (MADRS) by the U.S. Food and Drug Administration, 2007. Accessed June 27, 2008.

UpToDate Contents

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1. 成人に対する電撃療法（ECT）の概要 overview of electroconvulsive therapy ect for adults

English Journal

Major depression and bipolar disorders in CADASIL: a study using the DSM-IV semi-structured interview.

Valenti R, Pescini F, Antonini S, Castellini G, Poggesi A, Bianchi S, Inzitari D, Pallanti S, Pantoni L.SourceDepartment of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy Department of Neurological and Behavioral Sciences, University of Siena, Siena, Italy.
Acta neurologica Scandinavica.Acta Neurol Scand.2011 Dec;124(6):390-5. doi: 10.1111/j.1600-0404.2011.01512.x. Epub 2011 Mar 24.
Valenti R, Pescini F, Antonini S, Castellini G, Poggesi A, Bianchi S, Inzitari D, Pallanti S, Pantoni L. Major depression and bipolar disorders in CADASIL: a study using the DSM-IV semi-structured interview. Acta Neurol Scand: 2011: 124: 390-395. © 2011 John Wiley & Sons A/S. Objective - C
PMID 21428968

Assessing anxious features in depressed outpatients.

McClintock SM, Husain MM, Bernstein IH, Wisniewski SR, Trivedi MH, Morris D, Alpert J, Warden D, Luther JF, Kornstein SG, Biggs MM, Fava M, Rush AJ.SourceDepartment of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, USA. shawn.mcclintock@utsouthwestern.edu.
International journal of methods in psychiatric research.Int J Methods Psychiatr Res.2011 Dec;20(4):e69-82. doi: 10.1002/mpr.353. Epub 2011 Nov 4.
Both the 17-item Hamilton Rating Scale for Depression (HRSD(17) ) and 30-item Inventory of Depressive Symptomatology - Clinician-rated (IDS-C(30) ) contain a subscale that assesses anxious symptoms. We used classical test theory and item response theory methods to assess and compare the psychometric
PMID 22057975

Japanese Journal

F3:うつ病評価尺度(ハミルトン評価尺度など) (精神科臨床評価検査法マニュアル〔改訂版〕) -- (精神科臨床評価--特定の精神障害に関連したもの)

中根秀之
臨床精神医学 39(-), 214-220, 2010
NAID 40018783270

大うつ病の構造化面接と症状評価 (特集こころを測定する方法)

大坪天平
精神科 8(1), 22-29, 2006-01
NAID 40007150383

Related Pictures

Norfolk Airport Authority, Norfolk ดู รูป ใหญ่ ขึ้น HRSD logo tesda-hrsd-1 HRSD Mid-range Paint Gold Carve Patterns E hrsd canada compromises the details of Luna Optics LN-DM50-HRSD Digital Night Wallace Edwards & Sons, Incorporated

★リンクテーブル★

リンク元	「うつ病」「ハミルトンうつ病評価尺度」
関連記事	「HR」

「うつ病」

　　[★] 鬱病

英: depression
関: 抗うつ薬、抑うつ症、メランコリー melancholia

[show details]

鬱病 : 約 5,160,000 件
うつ病 : 約 23,500,000 件

分類

一次

大うつ病性障害(単極性障害)
双極性障害
気分変調性障害
気分循環性障害
特別な気分障害

産後うつ病
季節性気分障害

二次

薬物の使用による

疫学

世界的に有病率が高い(十ヵ国を対象とした研究では生涯有病率は平均8-12%、日本では3%、米国では17%であった(参考2))　　097G008(うつ病は世界的に主要な健康問題になっている。)

病因

脳のノルエピネフリン神経、セロトニン神経の働きに異常
レセルピンと鬱病の関係
レセルピン

血圧低下作用が臨床応用されていた
1931年に鎮静作用を示すことが明らかにされていた。
ノルエピネフリン神経におけるシナプス小胞への取り込みを阻害することによって

血圧↓→脳内モノアミン枯渇→うつ病発症→使われなくなる

評価

ベックうつ病自己評価尺度 Beck Depression Inventory BDI
ハミルトンうつ病評価尺度 Hamilton Rating Scale for Depression HRSD
自己評価抑うつ尺度 SDS：自記式で、重症度の評価が可能

鬱の診断基準

also see DSM-IV

1. 抑うつ気分

気分の落ち込みや何をしても癒されない気分や空虚感など

2. 興味、喜びの喪失

感情が麻痺した状態

診断

鑑別診断

KPS.973　←　あまり整理されていない印象

抑うつ気分を伴う適応障害
気分変調性障害
失調感情障害
統合失調症
大うつ病性障害
双極I型障害
境界性人格障害
低カリウム血症
短期精神病性障害
気分循環性障害
抗高血圧性毒性
ステロイド精神病性障害
甲状腺機能低下症
脳腫瘍
全身不全麻痺
アンフェタミン使用障害
コカイン使用障害
膵癌
肝炎
ウイルス感染後症候群
アルツハイマー型認知症
血管性認知症
晩発性アルツハイマー型認知症
早発性アルツハイマー型認知症
肝硬変
動脈硬化症
伝染性単核球症
甲状腺機能亢進症
潜在性悪性腫瘍
エイズ
シゾイド人格障害/統合失調質人格障害
失調型人格障害/統合失調型人格障害

IMD.1077 PSY.284

統合失調症：病初期にうつ状態。疎通性障害、幻覚・妄想の出現で鑑別される。
神経症

薬物性：糖質コルチコイド、降圧薬(レセルピン)、インターフェロン、レボドパ、抗精神病薬：服用歴で鑑別。

二次性：

内分泌疾患(クッシング症候群、シーハン症候群、甲状腺機能異常(甲状腺機能低下症(橋本病など))、糖尿病)、悪性腫瘍、膠原病：ホルモン検査、免疫学的検査、生化学検査にて鑑別を行う。

脳器質性疾患

脳血管障害：脳梗塞、脳出血など：CT、MRI、神経学的所見などから鑑別する
脳変性疾患：パーキンソン病、アルツハイマー病：CT、MRI、神経学的所見などから鑑別する

症状

昏迷、不安焦燥、精神活動抑制、微小思考

気分の憂うつだったり、寂しくなったりという抑うつ気分
将来に希望を持てなくて悲観的になり、考ええばかりおそってくる抑うつ気分
意欲、興味、関心の低下をきたす
朝に抑うつ気分がひどい
症状がひどいと自殺を試みる

治療

方針

1. うつ病であることを説明
2. 休息
3. 治癒の見通しを明らかにする
4. 重要決定は延期させる
5. 自殺しない約束

modality

薬物療法

効果の発現は服用開開始から1-2週間後で即効性はない。鬱症状が改善した後も4ヶ月継続すべき。(PSY.288)

軽症～中等症：SSRI, SNRI

重症：三環系抗うつ薬

精神療法

支持的精神療法
認知療法
力動的精神療法：再発防止、慢性期の治療

身体療法

電気痙攣療法 electroconvulsive therapy ECT：薬物療法に反応しない薬物治療抵抗性うつ病が適応。自殺の危険が迫っている例、身体疾患もしくは副作用により薬物療法に耐えられない例も適応。修正型電気痙攣療法もある。
高照度光療法：季節性感情障害 SADが適応。

薬物療法

MAOとうつ病
MAO inhibitorは脳モノアミン神経伝達物質の量を増やす
MAO inhibitor

モノアミン神経伝達物質が蓄積される
パーキンソン病やうつ病の病状をよくする

参考

1. [charged] うつ病の疫学、病因、および神経生物学 - uptodate [1]

「ハミルトンうつ病評価尺度」

　　[★]

英: Hamilton Rating Scale for Depression, HRSD, HAM-D
関: 抑うつ尺度、うつ病、精神症状、精神症状評価尺度

客観的にうつ病を評価する尺度

参考

GRID-HAMD-17 GRID-HAMD-21 構造化面接ガイド

http://www.jscnp.org/scale/grid.pdf

wikipedia en

http://en.wikipedia.org/wiki/Hamilton_Rating_Scale_for_Depression

「HR」

　　[★]

[1] "the ham-d scale". Retrieved 29 November 2012.

[2] Hedlund JL, Viewig BW (1979) The Hamilton rating scale for depression: a comprehensive review. Journal of Operational Psychiatry 10:149-165

[3] Hamilton, M (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry. 23: 56-62 doi:10.1136/jnnp.23.1.56 PMID 14399272

[4] Hamilton M (1966) Assessment of change in psychiatric state by means of rating scales. Proceedings of the Royal Society of Medicine 59 (Suppl. 1): 10-13 PMID 5922401

[5] Hamilton, M (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6: 278-96 PMID 6080235

[6] Hamilton, M (1969) Standardised assessment and recording of depressive symptoms. Psychiatria, Neurologia, Neurochirurgia. 72:201-205 PMID 5792061

[7] Hamilton, M (1980) Rating depressive patients. Journal of Clinical Psychiatry. 41: 21-24 PMID 7440521

[8] Bagby RM, Ryder AG, Schuller DR, Marshall MB (2004). "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?". American Journal of Psychiatry 161 (12): 2163–77. doi:10.1176/appi.ajp.161.12.2163. PMID 15569884.

[9] Berrios G E & Bulbena A (1990) The Hamilton Depression Scale and the Numerical Description of the Symptoms of Depression. In Bech P & Coppen A (ed) The Hamilton Scales, Heildeberg, Springer, pp80-92

[10] HDRS-17: Hamilton Depression Rating Scale (HDRS) at University of Florida, College of Medicine. Additional Questions Retrieved December 12, 2011.

[11] Williams JBW (1989) A structured interview guide for the Hamilton Depression Rating Scale. Archives of General Psychiatry 45: 742-747. PMID 3395203

[12] HRSD-7: 7-ITEM HAMILTON RATING SCALE FOR DEPRESSION: HAMD-7 in Official website of CANMAT: Canadian Network for Mood and Anxiety Treatments Accessed June 30, 2008, and McIntyre R, Kennedy S, Bagby RM, Bakish DJ (2002) Assessing full remission. Journal of Psychiatry and Neuroscience 27: 235-239 PMID 12174732

[13] HRSD-21: The Hamilton Rating Scale for Depression (to be administered by a health care professional) (presented as a service by GlaxoWellcome, February 1997) in UMass HealthNet: Consumer Health Resources for Massachusetts Residents: Official website of the Lamar Soutter Library, University of Massachusetts Medical School, Worcester, MA, 01655 USA. Retrieved June 27, 2008.

[14] HRSD-24: Hamilton Depression Rating Scale - 24 item (to be completed by a trained clinician) in FOCUS ON ALZHEIMER'S DISEASE: MEDAFILE; Site constructed and maintained by J. Wesson Ashford, M.D., Ph.D., Stanford / VA Alzheimer's Center, Palo Alto VA Hospital, 3801 Miranda Way, Palo Alto, CA 94304 USA. Retrieved June 27, 2008.

[15] HRSD-29: Williams JBW, Link MJ, Rosenthal NE, Terman M, Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders Version (SIGHSAD). New York Psychiatric Institute, New York, 1988

[16] Wechsler H, Grosser GH, Busfield BL Jr (1963) The depression rating scale: a quantitative approach to the assessment of depressive symptomatology. Archives of General Psychiatry. 9: 334-343 PMID 14045262

[17] Raskin A, Schulterbrandt J, Reatig N, McKeon JJ (1969) Replication of factors of psychopathology in interview, ward behavior and self-report ratings of hospitalized depressives. Journal of Nervous and Mental Diseases 148: 87-98 doi:10.1097/00005053-196901000-00010 PMID 5768895

[18] Inventory of Depressive Symptomatology (IDS) & Quick Inventory of Depressive Symptomatology (QIDS) in IDS/QIDS: Instruments in English and Multiple Translations by the University of Pittsburgh Epidemiology Data Center, 2008. Retrieved June 27, 2008.

[19] Psychiatric Rating Scales for Depression in www.neurotransmitter.net website by Shawn M. Thomas. Retrieved June 30, 2008.

匿名

検索

案内

案内

HRSD