Hamilton Anxiety Rating Scale (HAM-A)

Full Name *

Today's Date: *

Below is a list of phrases that describe certain feelings that people have. Rate the patients by finding the answer which best describes the extent to which he/she has these conditions. Select one of the five responses for each of the fourteen questions.

0 = Not present 1 = Mild 2 = Moderate 3 = Severe 4 = Very severe

1. Anxious mood: Worries, anticipation of the worst, fearful anticipation, irritability *

2. Tension: Feeling of tension, fatigability, startle response, moved to tears easily, trembling, feeling of restlessness, inability to relax *

3. Fears: Of dark, of strangers, of being left along, of animals, of traffic, of crowds. *

4. Insomnia: Difficulty in falling asleep, broken sleep, unsatisfying sleep and Fatigue on waking, dreams, nightmares, 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 chest, throbbing of vessels, fainting feelings, missing beat. *

10. Respiratory symptoms: Pressure or constriction in chest, choking feelings, sighing, dyspnea *

11. Gastrointestinal symptoms: Difficulty in swallowing, wind abdominal pain, burning sensation, abdominal fullness, nausea, vomiting, looseness of bowels, loss of weight, constipation *

12. symptoms: Frequency/urgency of urination, 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. *