Hamilton Anxiety Scale

Aka: Hamilton Anxiety Scale, HAM-A

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II. Background

  1. Authored by Max Hamilton in 1959
  2. Public domain anxiety rating scale

III. Criteria: Symptom Rating Scale (0=Not Present, 4=Disabling)

  1. Anxious Mood
    1. Worries
    2. Anticipates worst
  2. Tension
    1. Startles
    2. Cries easily
    3. Restless
    4. Trembling
  3. Fears
    1. Fear of the dark
    2. Fear of strangers
    3. Fear of being alone
    4. Fear of animal
  4. Insomnia
    1. Difficulty falling asleep or staying asleep
    2. Difficulty with Nightmares
  5. Intellectual
    1. Poor concentration
    2. Memory Impairment
  6. Depressed Mood
    1. Decreased interest in activities
    2. Anhedonia
    3. Insomnia
  7. Somatic Complaints: Muscular
    1. Muscle aches or pains
    2. Bruxism
  8. Somatic Complaints: Sensory
    1. Tinnitus
    2. Blurred Vision
  9. Cardiovascular Symptoms
    1. Tachycardia
    2. Palpitations
    3. Chest Pain
    4. Sensation of feeling faint
  10. Respiratory Symptoms
    1. Chest pressure
    2. Choking Sensation
    3. Shortness of Breath
  11. Gastrointestinal symptoms
    1. Dysphagia
    2. Nausea or Vomiting
    3. Constipation
    4. Weight loss
    5. Abdominal fullness
  12. Genitourinary symptoms
    1. Urinary Frequency or urgency
    2. Dysmenorrhea
    3. Impotence
  13. Autonomic Symptoms
    1. Dry Mouth
    2. Flushing
    3. Pallor
    4. Sweating
  14. Behavior at Interview
    1. Fidgets
    2. Tremor
    3. Paces

IV. Interpretation

  1. Above 14 symptoms are graded on scale
    1. Not present: 0
    2. Very severe symptoms: 4
  2. Criteria
    1. Mild Anxiety (minimum for Anxiolytic): 18
    2. Moderate Anxiety: 25
    3. Severe Anxiety: 30

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