Hamilton Anxiety Rating Scale

Clark, D.B. and Donovan, J.E. (1994) Reliability and Validity of the Hamilton Anxiety Rating scale in an Adolescent Sample. / am Acad Child Adolesc Psychiatry 33 354-360. 

In 24 patients treated with kava for generalized anxiety disorder for 4 weeks in an open, crossover, randomized trial, two dosage schedules were compared 120 mg od and 45 mg tds (5). There were significant reductions in mean Hamilton Anxiety Rating Scale scores, irrespective of dose schedule, treatment order, or sex. The impact of adverse effects was relatively low, and only one patient had to withdraw from the study (tds schedule) because of nausea. There was daytime drowsiness in 33% of patients taking the thrice-daily regimen compared with 9% in those taking a once-daily dose. 

Patients with panic disorder should be seen every 2 weeks during the first few weeks to adjust medication doses based on symptom improvement and to monitor side effects. Once stabilized, they can be seen every 2 months. The Hamilton Rating Scale for Anxiety (score less than or equal to 7 to 10) can be used to measure anxiety, and the Sheehan Disability Scale (with a goal of less than or equal to 1 on each item) can be used to measure for disability. During drug discontinuation, the frequency of appointments should be increased. 

The initial study of clonazepam in social phobia conducted by Versiani et al. [1989] showed an overall benefit of the drug. This 8-week, open trial of 40 subjects displayed statistically significant lowering of scores on the efficacy variables, which included the Clinical Global Improvement and Severity Scales [Guy 1976], Liebowitz Social Anxiety Scale [liebowitz 1987], Hamilton Anxiety Scale [M. Hamilton 1959], and the Sheehan Disability Scale [D. V. Sheehan 1986]. The mean dose of clonazepam was 3.9 mg/day [SD 0.5 mg]. Subjects in this study reported high rates of side effects, including sleepiness [67.5%], loss of libido [67.5%], and memory problems [35%]. 

The Hamilton Rating Scale for Anxiety (HRSA) is the most widely used instrument for the assessment of anxiety symptoms in patients suffering from diagnosed anxiety disorders. The HRSA consists of 14 items and focuses to a great extent (7/14 items) on somatic symptoms (Hamilton, 1959). 

Hamilton Anxiety Scale (HAM-A or HAM-AS or HAMRS) Clinician-rated 14 items, 5-point scales scores of >18-20 for moderate anxiety Consists of subscales to measure somatic and psychic anxiety... 

Hamilton Depression Scale. The HAMD is one of the most widely used tests to evaluate the severity of depressive illness quantitatively in adults. The most widely used form of this test contains 21 items covering a broad range of symptomatology, with a three- to five-point scale for most items. The minimum time required to complete this test is usually 10 to 20 minutes, and it requires a skilled interviewer. Either the present time or the period within the last week is rated. Six subscales are obtained in the HAMD anxiety/somatization, weight, cognitive disturbance, diurnal variation, retardation, and sleep disturbance. 

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