The Hamilton Anxiety Scale

The Hamilton Anxiety Scale is one of the most used psychological questionnaires. to clarify the degree of anxiety that a person suffers. It is, therefore, not a diagnostic instrument, but a useful and highly effective resource to assess the state the patient is in, what their psychosomatic symptoms are, their fears and their cognitive processes.

One fact about this interesting scale draws attention. It was designed in 1959 by Max R. Hamilton and today it remains one of the most used. If there was something that this professor of psychiatry, and later president of the British Psychological Societyis that not all anxiety states are the same.

I did not want to define another instrument to diagnose a disorder. I sought to define a highly rigorous resource with which to evaluate the degree of severity of anxiety in a person, also differentiating psychic anxiety from somatic anxiety due to its importance when defining the capacity of control that people have over this very exhausting reality.

Later, in 1969, Dr. Hamilton wanted to go a little further and improve the scale. Thus, among those items focused on assessing somatic anxiety, made a distinction between muscular somatic signs and sensory somatic signs. In this way, and with this degree of refinement when designing a test that is as tight as possible, we already sense an obvious clue on this issue.

Each person experiences anxiety in a particular way. There are no two similar realities, therefore, not all of us use the same therapeutic strategies.. Tests such as the one we detail below are very suitable for maximally personalizing treatments based on the particular needs of each patient.

Purpose of the Hamilton Anxiety Scale

The Hamilton Anxiety Scale is a clinical assessment instrument that It is used to measure a person’s level of anxiety. It is useful in both children and adults. Likewise, it is an instrument that both doctors and psychiatrists can use, but keeping in mind that it does not determine the diagnosis of a specific disorder (although it can help).

Furthermore, there is a problem with this clinical resource that health professionals are already realizing. The Hamilton Anxiety Scale is freely accessible, Anyone can download the instrument or even take the test online. Thus, it is common for many people to go to their doctors with the diagnosis made: ““I suffer from severe anxiety.”

It must be said that this is not appropriate. This type of test, like any other type of clinical evaluation, must be done by specialized professionals. Even more, the Hamilton anxiety scale has another item where the researcher himself must assess the state in which the patient has performed the test.

It is a priority, therefore, that we be rigorous in this aspect, because as revealed in studies such as those carried out by psychiatrists Katherine Shear and Vander Bilt in a study, In the Hamilton anxiety scale, the interview itself during the administration of the test is key to a good diagnosis.

Items measured by the Hamilton Anxiety Scale

This instrument consists of 14 items. Each question has five answer options, ranging from not present until very severe. Thus, a score of 17 or less indicates mild anxiety. A score between 18 and 24 points would already give us a clue of a moderate state of anxiety. Finally, If we obtain a score between 24 to 30, it would indicate a severe state of anxiety.

Let’s see below those 14 items that make up the test:

Anxious mind: constant worries, anxiety when thinking or imagining certain thingsalways anticipate the worst…Tension: trembling, desire to cry, feeling of alarm…Fears: fear of being alone, of the darkness, of something unforeseen happening…Insomnia.Cognitive problems: difficulty deciding, concentrating, reflecting, memory failures…Mood: discouragement, waking up with negativity and the feeling that it is going to be a bad day, irritation, bad mood.Muscular somatic: bruxism, tremors, muscle stiffness, muscle pain, trembling voice…Sensory somatic: tinnitus, blurred vision, feeling of cold or heat, feeling of weakness…Cardiovascular symptoms: tachycardia or sudden punctures in the chest. Respiratory symptoms: feeling of lack of air, pressure, suffocation…Gastrointestinal symptoms: problems swallowing, digestion, constipation or diarrhea… Genitourinary symptoms: constant urination, lack of libido…Autonomous symptoms: dry mouth, paleness, sweating, prickly skin…Professional assessment: here the expert makes an assessment of how he or she has seen the patient in general.

To conclude, only one essential aspect can be emphasized. The Hamilton Anxiety Scale is a freely accessible resource, we know. We can do it if we wish. Nevertheless, It is our psychiatrists or psychologists who are truly qualified to make the evaluation and diagnosis.

Later, and based on the result, one strategy or another will be carried out. Dr. Hamilton’s purpose in the 1960s was to be able to obtain an adjusted and reliable profile of each person’s anxiety level. Only in this way will we be able to act in the best way, in the most accurate way.

And in these cases, assessing aspects such as the patient’s tone of voice, their posture, the clarity of understanding or not the questions are key to carrying out a correct evaluation.

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