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HAMILTON ANXIETY RATING SCALE (HAM-A)
Hamilton M. (1959) The assessment of anxiety states by rating. Br J Med Psychol. 32:50-55.

For each item write in the box the number that best characterises the patient
during the past week

1 - ANXIOUS MOOD This item covers the emotional condition of uncertainty about the future, ranging from worry, insecurity, irritability and apprehension to overpowering dread.

 

0

Absent.

 

1

Doubtful whether the patient is more insecure or irritable than usual.

 

2

The patient is clearly in a state of anxiety, apprehension or irritability, which he may find difficult to control. However, the worrying still is about minor matters and thus without influence on the patient's daily life.

 

3

At times the anxiety or insecurity is more difficult to control because the worrying is about major injuries or harms which might occur in the future. Has occasionally interfered with the patient's daily life.

 

4

The feeling of dread is present so often that it markedly interferes with the patient's daily life.

2 - TENSION This item includes inability to relax, nervousness, bodily tensions, trembling and restless fatigue.

 

0

Absent.

 

1

The patient seems somewhat more nervous and tense than usual.

 

2

Patient is clearly unable to relax and is full of inner unrest, which he finds difficult to control, but it is still without influence on the patient's daily life.

 

3

The inner unrest and nervousness is so intense or frequent that it occasionally interferes with the patient's daily work.

 

4

Tensions and unrest interfere with the patient's life and work at all times.

3 - FEARS This item includes fear of being in a crowd, of animals, of being in public places, of being alone, of traffic, of strangers, of dark etc. It is important to note whether there has been more phobic anxiety during the present episode than usual.

 

0

Absent.

 

1

Doubtful whether present.

 

2

The patient experiences phobic anxiety but is able to fight it.

 

3

It is difficult to fight or overcome the phobic anxiety, which thus to some extent interferes with the patient's daily life and work.

 

4

The phobic anxiety clearly interferes with the patient's daily life and work.

4 - INSOMNIA This item covers the patient's subjective experience of sleep duration and sleep depth during the three preceding nights. Note: Administration of hypnotics or sedatives is disregarded

 

0

Usual sleep duration and sleep depth

 

1

Sleep duration is possibly or slightly reduced (e.g. due to difficulties falling asleep), but no change in sleep depth.

 

2

Sleep depth is also reduced, sleep being more superficial. Sleep as a whole is somewhat disturbed.

3

Sleep duration and sleep depth is markedly changed. Sleep periods total only a few hours per 24 hours.

4

Sleep depth is so shallow that the patient speaks of short periods of slumber or dozing, but no real sleep.


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