The Hamilton Anxiety Rating Scale (HAM-A) is a clinical instrument used to assess the severity of anxiety symptoms. Developed by Max Hamilton in the late 1950s, it consists of 14 items that evaluate both mental and physical symptoms of anxiety during a clinical interview.

Participant Information

  • Name:
  • Phone:

Assessment Items

Each item is rated on a scale from 0 to 4:

  • a. Not present (0 points)
  • b. Mild (1 point)
  • c. Moderate (2 points)
  • d. Severe (3 points)
  • e. Very severe (4 points)
  1. Anxious mood: Worries, anticipation of the worst, fearful anticipation, irritability.
  2. Tension: Feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, and inability to relax.
  3. Fears: Of dark, of strangers, of being left alone, of animals, of traffic, of crowds.
  4. Insomnia: Difficulty in falling asleep, broken sleep, unsatisfying sleep, and fatigue on waking, dreams, nightmares, and night terrors.
  5. Intellectual: Difficulty in concentration, poor memory.
  6. Depressed mood: Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.
  7. Somatic (muscular): Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
  8. Somatic (sensory): Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.
  9. Cardiovascular symptoms: Tachycardia, palpitations, pain in the chest, throbbing of vessels, fainting feelings, missing beat.
  10. Respiratory symptoms: Pressure or constriction in the chest, choking feelings, sighing, dyspnea.
  11. Gastrointestinal symptoms: Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.
  12. Genitourinary symptoms: Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence.
  13. Autonomic symptoms: Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.
  14. Behavior at interview: Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.

Results and Interpretation

Score RangeInterpretation
0-10 pointsNo Indication of Anxiety Disorder: Little or no indication of common symptoms.
11-19 pointsModerate Indication of Anxiety Disorder: Suggests a moderate level of common symptoms.
20-29 pointsIndication of Moderate to Severe Anxiety Disorder: Indicates symptoms common to moderate/severe cases.
30+ pointsStrong Indication of Severe Anxiety Disorder: Suggests a strong indication of severe symptoms.

Disclaimer: This assessment is not a substitute for a professional diagnosis. You are encouraged to schedule an appointment with a doctor or mental health professional to address concerns.