HAM-A – My Soul Space

Hamilton Anxiety Rating Scale (HAM-A)

The scale includes 14 graded symptoms, the total of which provides a general measure of the level of anxiety.
It is usually administered before starting treatment and then applied periodically to assess the degree of improvement.

Please choose the symptom description that most accurately reflects your condition.

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1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood

None

Occasional worry or mild tension, generally manageable

Frequent anxious thoughts, noticeable unease most of the day

Persistent fear or apprehension throughout most of the day

Constant anxiety, overwhelming dread or panic interfering with function

2. Tension — fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying

None

Slight nervous tension, occasional restlessness

Frequent episodes of uneasiness, noticeable difficulty relaxing

Continuous inner tension, marked restlessness or trembling

Near-constant agitation, unable to stay calm or composed

3. Fears — of darkness, strangers, being alone, animals, crowds, or traffic

None

Occasional mild fears in specific situations

Recurrent fears causing discomfort or avoidance

Persistent fears limiting daily functioning

Incapacitating fear or panic in many situations

4. Insomnia — difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares

None

Occasional trouble falling asleep

Frequent awakenings or restless sleep

Persistent sleep disturbance causing fatigue

Near-total sleeplessness or severe sleep disruption

5. Cognitive difficulties — poor concentration, memory problems, or mental confusion

None

Slight forgetfulness or reduced focus

Noticeable lapses in concentration or recall

Frequent confusion or inability to sustain attention

Constant disorientation or inability to think clearly

6. Depressed mood — loss of interest, sadness, apathy, mood swings

None

Occasional sadness or loss of interest

Persistent low mood and emotional fluctuation

Deep sadness, marked loss of pleasure or motivation

Continuous depression, emotional paralysis or despair

7. Behavior during the interview — physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils)

None

Slight tension or minor nervous movements

Noticeable restlessness or muscle tension

Marked physical agitation throughout the interview

Extreme, uncontrollable physical manifestations of anxiety

8. Somatic (sensory) symptoms — blurred vision, tinnitus, hot or cold flashes, sensations of weakness

None

Occasional sensory disturbances

Recurrent discomfort or mild sensory episodes

Frequent or distressing sensory symptoms

Constant sensory disturbance, disabling intensity

9. Somatic (muscular) symptoms — muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor

None

Slight muscle tension or stiffness

Frequent aches or noticeable tension

Continuous muscular discomfort or spasms

Persistent severe pain or involuntary contractions

10. Cardiovascular symptoms — chest pain, palpitations, irregular heartbeat, pulsation, faintness

None

Occasional palpitations or brief heart awareness

Recurrent palpitations or mild chest tightness

Persistent chest discomfort or racing heartbeat

Disabling cardiovascular distress or fainting sensations

11. Respiratory symptoms — shortness of breath, sighing, feelings of choking or tightness

None

Occasional shortness of breath or sighing

Frequent episodes of respiratory discomfort

Persistent tightness or difficulty breathing

Near-constant choking or suffocating sensation

12. Gastro-intestinal symptoms — burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation

None

Occasional stomach upset or mild nausea

Frequent digestive discomfort or irregularity

Persistent pain, nausea, or bowel disturbance

Constant gastrointestinal distress interfering with eating

13. Genito-urinary symptoms — frequent urination, sexual dysfunction, loss of libido

None

Slight changes in urination or libido

Noticeable frequency or mild sexual difficulties

Persistent sexual dysfunction or urinary urgency

Disabling genito-urinary problems, marked loss of function

14. Autonomic (nervous-system) symptoms — dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end

None

Occasional mild autonomic responses

Frequent sweating, flushing, or light-headedness

Persistent autonomic disturbances

Constant, disabling autonomic instability

Total Score

Hamilton Anxiety Rating Scale (HAM-A)

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