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Mental Health Assessments > Hamilton Anxiety Rating Scale

Hamilton Anxiety Rating Scale

The HAM-A is popular and well-established clinician-rating scale used to measure the presence and severity of anxiety symptoms among adults, adolescents and children. The scale consists of 14 items and takes 5 to 15 minutes to complete. Each item is defined by a series of symptoms, and measures both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety) Below is a list of phrases that describe certain feeling that people have. Rate the patients by finding the answer which best describes the extent to which he/she has these conditions. Select one of the five responses for each of the fourteen questions.

Sources: Maier W, Buller R, Philipp M, Heuser I. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 1988;14(1):61–8.
Brody, A. L., Mandelkern, M. A., London, E. D., Childress, A. R., Lee, G. S., Bota, R. G., ... & Jarvik, M. E. (2002). Brain metabolic changes during cigarette craving. Archives of General Psychiatry, 59(12), 1162.

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Item 0
Not
1
Mild
2
Moderate
3
Severe
4
Very Severe
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 dark, of strangers, of being left alone, of animals, of traffic, of crowds.
4 Insomnia Difficulty in falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.
5 Intellectual Difficulty in concentration, poor memory.
6 Depressed Mood Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.
7 Somatic (muscular) Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
8 Somatic (sensory) Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.
9 Cardiovascular Symptoms Tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.
10 Respiratory Symptoms Pressure or constriction in chest, choking feelings, sighing, dyspnea.
11 Gastrointestinal Symptoms Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.
12 Genitourinary Symptoms Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence.
13 Autonomic Symptoms Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.
14 Behavior at Interview Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.

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