Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
HDRS (HAM-D)
Hamilton Depression Rating Scale
Purpose : Evaluate for signs of depression
Admin time : 10-20 min
User Friendly : High
Administered by : Healthcare provider
Content : The original HDRS included 21 questions, only 17 of these questions are scored
Author : Hamilton MAX, 1960
Copyright : Public domain. Free to use
HDRS (HAM-D)
Advantages:
-
free to use
-
still widely used to measure the effectiveness of antidepressant medication (serial testing in clinical practice)
Disadvantages:
-
inter-rater reliability is affected by the level of training undertaken by the interviewer
-
criticized for burying important features of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) diagnostic criteria such as feelings of worthlessness and anhedonia]. This is likely to be because it is more than 50 years old and designed before the DSM-IV criteria were established.
Accuracy :
sensitivity 93% and specificity 97% (Raimo S, 2015)
HARS (HAM-A)
Hamilton Anxiety Rating Scale
Purpose : Rate the severity of a patient's anxiety
The scale predates the current definition of generalized anxiety disorder (GAD). However, it covers many of the features of GAD and can be helpful also in assessing its severity. The major value of HAM-A is to document the results of pharmacotherapy or psychotherapy, rather than as a diagnostic or screening tool.
Admin time : 15-20 min
User Friendly : High
Administered by : Healthcare provider
Content : Based on 14 parameters, including anxious mood, tension, fears, insomnia, somatic complaints and behavior at the interview
Author : Hamilton MAX, 1959
Copyright : Free to use
HARS (HAM-A)
Advantages:
-
Free to use
-
Computer administered Hamilton Anxiety Rating Scale has shown to be almost as effective as the clinician-administered version.
Disadvantages:
-
Interpretation of the subjects response are clinician dependent
-
Created before the DSM-III, which changed generalized anxiety disorder into a disorder of worry (which is not covered by HAM-A).
-
DSM-IV defined generalized anxiety disorder as excessive and uncontrollable worry in which HAM-A doesn't accurately cover the main symptom (worry)
-
The current HAM-A scale is poor at showing a difference between generalized anxiety disorder and depression due to changes in the DSM
Accuracy :
sensitivity 85.7% , and specificity 63.5% (Kummer A, 2010).
This Tool is used in Depression
Back To : Depression
Depression is one of 4 sub-domains of the
Psychological Assessment
Back To : Psychological Assessment
The Psychological Assessment is one of 8 domains of the
Comprehensive Geriatric Assessment (CGA)
Back To : Comprehensive Geriatric Assessment