What is the Hamilton Anxiety Rating Scale (HAM-A)?

The HAM-A is a clinician-administered rating scale designed to measure the severity of anxiety symptoms in adults. It consists of 14 items covering both psychological and somatic symptoms of anxiety.

Who developed the HAM-A and when?

Developed by Max Hamilton in 1959, it has become one of the most widely used anxiety assessment tools in clinical practice and research.

What type of assessment is the HAM-A?

It is primarily a clinician-administered interview-based rating scale, though self-report versions have been developed.

What does the HAM-A assess?

• Psychological Anxiety: Worries, fears, tension, difficulty concentrating
• Somatic Anxiety: Physical symptoms like muscular tension, sensory symptoms
• Autonomic Symptoms: Cardiovascular, respiratory, gastrointestinal symptoms
• Behavioral Symptoms: Restlessness, insomnia, irritability

How is the HAM-A scored?

Each item is rated from 0-4 (0=not present, 1=mild, 2=moderate, 3=severe, 4=very severe), with total scores ranging from 0-56.

What are the score interpretations?

• 0-7: No anxiety
• 8-14: Mild anxiety
• 15-23: Moderate anxiety
• 24+: Severe anxiety

What are the strengths of the HAM-A?

Well-validated, widely used in clinical trials, sensitive to treatment changes, comprehensive coverage of anxiety symptoms.

What are the limitations?

Requires trained administrator, may confound anxiety with depression, focuses more on somatic symptoms.