HAM-D (SIGH-D) Clinical Assessment

Self-Report & Observation

1. Depressed Mood

0: Absent 1: Indicated only on questioning 2: Spontaneously reported verbally 3: Communicated non-verbally (Face, posture, weeping) 4: Virtually ONLY these feeling states reported

Self-Report

2. Feelings of Guilt

0: Absent 1: Self-reproach, feels he/she has let people down 2: Ideas of guilt or rumination over past errors 3: Illness is a punishment. Delusions of guilt 4: Accusatory voices or threatening hallucinations

Self-Report

3. Suicide

0: Absent 1: Feels life is not worth living 2: Wishes he/she were dead 3: Suicidal ideas or gesture 4: Serious attempt at suicide

Self-Report

4. Insomnia: Early

0: No difficulty 1: Occasional difficulty (>30 mins to fall asleep) 2: Nightly difficulty

Self-Report

5. Insomnia: Middle

0: No difficulty 1: Restless/disturbed during night 2: Waking during night (any out of bed rates 2, except to void)

Self-Report

6. Insomnia: Late

0: No difficulty 1: Waking early but goes back to sleep 2: Unable to fall asleep again if gets out of bed

Self-Report

7. Work and Activities

0: No difficulty 1: Thoughts of fatigue/weakness related to work/hobbies 2: Loss of interest; feelings of pushing self 3: Decreased time in activities (<3 hours/day excluding chores) 4: Stopped working because of present illness

Observation Only

8. Retardation

0: Normal speech and thought 1: Slight retardation at interview 2: Obvious retardation at interview 3: Interview difficult 4: Complete stupor

Observation Only

9. Agitation

0: None 1: Fidgetiness 2: Playing with hands, hair, etc. 3: Moving about, can't sit still 4: Hand-wringing, nail-biting, hair-pulling

Self-Report

10. Anxiety (Psychic)

0: No difficulty 1: Subjective tension and irritability 2: Worrying about minor matters 3: Apprehensive attitude in face/speech 4: Fears expressed without questioning

Self-Report

11. Anxiety (Somatic)

0: Absent 1: Mild 2: Moderate 3: Severe 4: Incapacitating

Self-Report

12. Somatic Symptoms (GI)

0: None 1: Loss of appetite; heavy feeling in abdomen 2: Difficulty eating without urging; Constipation

Self-Report

13. Somatic Symptoms (General)

0: None 1: Heaviness in limbs/back. Muscle aches, fatigue 2: Any clear-cut, persistent somatic symptom

Self-Report

14. Genital Symptoms

0: Absent 1: Mild (Partial loss of interest) 2: Severe (Total loss of libido)

Self-Report

15. Hypochondriasis

0: Not present 1: Self-absorption (bodily) 2: Preoccupation with health 3: Frequent complaints, requests for help 4: Hypochondriacal delusions

Measurement

16. Weight Loss

0: No weight loss 1: Probable/Measured >0.5kg in one week 2: Definite/Measured >1.0kg in one week

Observation / Insight

17. Insight

0: Acknowledges being depressed and ill 1: Acknowledges illness but blames external factors 2: Denies being ill at all

Hamilton Depression Rating Scale

Privacy & Clinical Accuracy

1. Depressed Mood

2. Feelings of Guilt

3. Suicide

4. Insomnia: Early

5. Insomnia: Middle

6. Insomnia: Late

7. Work and Activities

8. Retardation

9. Agitation

10. Anxiety (Psychic)

11. Anxiety (Somatic)

12. Somatic Symptoms (GI)

13. Somatic Symptoms (General)

14. Genital Symptoms

15. Hypochondriasis

16. Weight Loss

17. Insight

Privacy & Clinical Accuracy

1. Depressed Mood

2. Feelings of Guilt

3. Suicide

4. Insomnia: Early

5. Insomnia: Middle

6. Insomnia: Late

7. Work and Activities

8. Retardation

9. Agitation

10. Anxiety (Psychic)

11. Anxiety (Somatic)

12. Somatic Symptoms (GI)

13. Somatic Symptoms (General)

14. Genital Symptoms

15. Hypochondriasis

16. Weight Loss

17. Insight

SIGH-D Structured Script

Opening

Specific Probes