The Hamilton Anxiety Rating Scale (HAM-A/HARS) online calculator

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The Hamilton Anxiety Rating Scale evaluates anxiety levels based on clinical questions, quantifies the severity of anxiety syndrome, and is often used to evaluate antipsychotic drugs.

It consists of 14 indicators, each of which is defined by several symptoms. Each indicator is rated on a 5-point scale from 0 (none) to 4 (severe). The Hamilton Anxiety Scale can help objectify and rate the severity of a patient’s anxiety.

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The Hamilton Anxiety Scale can help objectify and assess the severity of a patient’s anxiety.

Each parameter is assessed according to the level of severity:

Point Values:

0=Not Present
+1=Mild
+2=Moderate
+3=Severe
+4=Very Severe

To assess the Hamilton anxiety scale, it is necessary to add the selected points.

1. Anxious mood: Worries, anticipation of the worst, fearful anticipation, irritability.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
2. Tension: Feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
3. Fears: Of dark, of strangers, of being left alone, of animals, of traffic, of crowds.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
4. Insomnia: Difficulty in falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
5.  Intellectual: Difficulty in concentration, poor memory.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
6. Depressed mood: Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
7. Somatic (muscular): Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
8. Somatic (sensory): Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
9. Cardiovascular symptoms: Tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
10 . Respiratory symptoms: Pressure or constriction in chest, choking feelings, sighing, dyspnea.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
11. Gastrointestinal symptoms: Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
12. Genitourinary symptoms: Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation,loss of libido, impotence.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
13. Autonomic symptoms: Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4
14. Behavior at interview: Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.Not Present0
 Mild+1
 Moderate+2
 Severe+3
 Very Severe+4

Score interpretation:

  • Scores ≤17 indicate mild anxiety severity.
  • Scores of 18-24 indicate mild to moderate anxiety severity
  • Scores of 25-30 indicate moderate to severe anxiety severity
  • Scores >30 indicate severe anxiety

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Literature:

  1. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32:50–55 https://pubmed.ncbi.nlm.nih.gov/13638508/
  2. 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 https://pubmed.ncbi.nlm.nih.gov/2963053/  Per Bech. Measuring States of
  3. Anxiety with Clinician-Rated and Patient-Rated Scales, Different Views of Anxiety Disorders. 2011, DOI: 10.5772/21246 https://www.intechopen.com/books/different-views-of-anxiety-disorders/measuring-states-of-anxiety-with-clinician-rated-and-patient-rated-scales


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