Cited by 1,148Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingPsychological Testing and Assessment

The Hamilton Depression Rating Scale: Has the Gold Standard Become a Lead Weight?

Bagby, R. Michael, Ryder, Andrew G., Schuller, Deborah R., Marshall, Margarita B.·2004·American Journal of Psychiatry

Abstract

OBJECTIVE: The Hamilton Depression Rating Scale has been the gold standard for the assessment of depression for more than 40 years. Criticism of the instrument has been increasing. The authors review studies published since the last major review of this instrument in 1979 that explicitly examine the psychometric properties of the Hamilton depression scale. The authors' goal is to determine whether continued use of the Hamilton depression scale as a measure of treatment outcome is justified. METHOD: MEDLINE was searched for studies published since 1979 that examine psychometric properties of the Hamilton depression scale. Seventy studies were identified and selected, and then grouped into three categories on the basis of the major psychometric properties examined-reliability, item-response characteristics, and validity. RESULTS: The Hamilton depression scale's internal reliability is adequate, but many scale items are poor contributors to the measurement of depression severity; others have poor interrater and retest reliability. For many items, the format for response options is not optimal. Content validity is poor; convergent validity and discriminant validity are adequate. The factor structure of the Hamilton depression scale is multidimensional but with poor replication across samples. CONCLUSIONS: Evidence suggests that the Hamilton depression scale is psychometrically and conceptually flawed. The breadth and severity of the problems militate against efforts to revise the current instrument. After more than 40 years, it is time to embrace a new gold standard for assessment of depression.

Integrity signals

Registry

Crossref · 10.1176/appi.ajp.161.12.2163

Cites

88 of 88 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Bagby, R. M., Ryder, A. G., Schuller, D. R., & Marshall, M. B.
Affiliations
Centre for Addiction and Mental Health (CA)
Venue
American Journal of Psychiatry
Published
2004-12
Volume
161
Issue
12
Pages
2163-2177
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
OpenAlex
W2124295269
Cited by
1,148
References
88
Citations by year
2026: 36 · 2025: 60 · 2024: 47 · 2023: 51 · 2022: 60 · 2021: 91 · 2020: 66 · 2019: 55 · 2018: 51 · 2017: 43 · 2016: 46 · 2015: 61 · 2014: 71 · 2013: 68 · 2012: 52
FWCI
39.88
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • 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
  • Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords
Hamilton Depression Rating Scale, depression assessment, psychometric properties, reliability statistics, validity, content validity, factor structure, treatment outcome assessment, depression severity
MeSH terms
Depressive Disorder, Factor Analysis, Statistical, Humans, Personality Inventory, Psychiatric Status Rating Scales, Psychometrics, ROC Curve, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review