What does the HAMD mean?

Leucht, Stefan; Fennema, Hein; Engel, Rolf; Kaspers–Janssen, Marion; Lepping, Peter; Szegedi, Armin

doi:10.1016/j.jad.2012.12.001

Cited by 211Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and Testing

What does the HAMD mean?

Leucht, Stefan, Fennema, Hein, Engel, Rolf, Kaspers–Janssen, Marion, Lepping, Peter, Szegedi, Armin·2013·Journal of Affective Disorders

DOI 10.1016/j.jad.2012.12.001

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Abstract

Little is known about the clinical relevance of the Hamilton Rating Scale for Depression (HAMD-17) total scores. It is unclear how total scores translate into clinical severity, or what commonly used measures for response (reduction from baseline of ≥ 50% in the total score) and remission (total HAMD-17 score ≤ 7) mean from a clinical perspective. We therefore compared: (a) the percentage and absolute change in the HAMD-17 total scores with Clinical Global Impression-Improvement (CGI-I); (b) the absolute and percentage change in the HAMD-17 total scores with Clinical Global Impression-Severity (CGI-S) absolute change; and (c) the percentage and absolute change in the HAMD-17 total scores with CGI-I in the subgroups of patients with ≤ median and > median HAMD-17 total scores at baseline. The method used was equipercentile linking of HAMD-17 and CGI ratings from 43 drug trials in patients with Major Depressive Disorder (MDD) (n = 7131). Our results confirm the validity of the commonly used measures for remission and response in MDD trials: a CGI-I score of 2 ('much improved') corresponded to a reduction from baseline of > 50% and < 60%, and a CGI-I score of 1 ('very much improved') to a reduction of > 75% and < 85%. The CGI-S score of 1 ('normal., not at all ill') corresponded to the HAMD-17 total score of < 5 and the CGI-S score of 2 ('borderline mentally ill') to the score between 6 and 8. An effect of baseline illness severity was observed.

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Only one study was obtained that provides some evidence for the fully symptomatic cut-off.
“Only one study was obtained that provides some evidence for the fully symptomatic cut-off (Leucht et al. 2013).”
From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Leucht et al. 2013
Using CGI-S of 2 or 3 as the gold standard, Leucht et al. (2013) advise a HAMD-17 threshold of ≥7 or ≥14, respectively.
“By using the CGI-S of 2 or 3 as the gold standard, Leucht et al. (2013) advise a HAMD-17 threshold of ⩾7 or ⩾14, respectively.”
From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Leucht et al. 2013
An SSRI-placebo mean difference of up to three points on the HDRS corresponds to a clinical judgement of 'no change' in the person's condition.
“One study has shown that an SSRI-placebo mean difference of up to three points on the HDRS corresponds to a clinical judgement of ‘no change’ in the person’s condition.”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [23]
Global clinical ratings of 'minimal improvement' correspond to approximately a seven-point change on the HDRS or an SMD of 0.875.
“Thus, global clinical ratings of ‘minimal improvement’ correspond to approximately a seven-point change on the HDRS23 or an SMD of 0.875.”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [23]

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Authors: Leucht, S., Fennema, H., Engel, R., Kaspers–Janssen, M., Lepping, P., & Szegedi, A.
Affiliations: TUM Klinikum (DE)
MSD (Netherlands) (NL)
Ludwig-Maximilians-Universität München (DE)
Betsi Cadwaladr University Health Board (GB)
Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
ORCID: Leucht, Stefan
Engel, Rolf
Lepping, Peter
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2013-06
Volume: 148
Issue: 2-3
Pages: 243-248
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2012.12.001
OpenAlex: W1977670030
Cited by: 211
References: 32
Citations by year: 2026: 24 · 2025: 21 · 2024: 19 · 2023: 15 · 2022: 22 · 2021: 16 · 2020: 26 · 2019: 22 · 2018: 13 · 2017: 10 · 2016: 5 · 2015: 8 · 2014: 9
FWCI: 5.39
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: Hamilton Depression Rating Scale, Clinical Global Impression Scale, CGI-I, CGI-S, major depressive disorder, depression severity, treatment response, remission, equipercentile linking, antidepressant trials
MeSH terms: Adult, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Reproducibility of Results, Treatment Outcome

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