---
title: "Hamilton Anxiety Rating Scale (HAM-A): Score Online"
url: "https://www.ellomind.com/ai-tools-for-psychologists/scales/hamilton-anxiety-rating-scale/"
description: "Hamilton Anxiety Rating Scale (HAM-A) scoring reference for clinicians: rate the 14 items, with the scoring key, severity bands and a ready-made AI prompt to score de-identified responses. Free, India-first."
---
Anxiety 

# Hamilton Anxiety Rating Scale (HAM-A)

Clinician-rated · 14 items · 10 min

Rate and score the Hamilton Anxiety Rating Scale (HAM-A), a standard clinician-rated measure of anxiety severity. Fourteen items across psychic and somatic anxiety, shown in full, with an AI prompt to score de-identified responses.

Copy prompt Download as .md

**De-identify first.** The prompt runs in your own AI assistant. Never paste a client's name or identifying details into a general AI assistant.

## What it measures

The HAM-A, introduced by Max Hamilton in 1959, is one of the first and most widely used clinician-rated anxiety scales. It rates fourteen areas, split between psychic anxiety (mood, tension, fears, concentration) and somatic anxiety (muscular, sensory, cardiovascular, respiratory, gastrointestinal and other physical symptoms).

It is completed by the clinician after interview, and is most useful for rating severity and tracking change rather than for diagnosis.

## The HAM-A items

Rate each area 0 (not present) to 4 (very severe) from the interview.

1. Anxious mood (worry, anticipation of the worst)
2. Tension (startle, fatigability, inability to relax)
3. Fears (of the dark, strangers, being alone, crowds)
4. Insomnia (difficulty falling asleep, broken sleep, fatigue on waking)
5. Intellectual (difficulty concentrating, poor memory)
6. Depressed mood (loss of interest, low mood, diurnal variation)
7. Somatic — muscular (aches, stiffness, twitching, grinding teeth)
8. Somatic — sensory (tinnitus, blurred vision, hot and cold flushes)
9. Cardiovascular symptoms (palpitations, chest pain, throbbing)
10. Respiratory symptoms (chest pressure, choking, shortness of breath)
11. Gastrointestinal symptoms (difficulty swallowing, pain, nausea)
12. Genitourinary symptoms (frequency, urgency, loss of libido)
13. Autonomic symptoms (dry mouth, flushing, sweating, giddiness)
14. Behaviour at interview (fidgeting, tremor, restlessness)

**Response options:** 0 Not present (0), 1 Mild (1), 2 Moderate (2), 3 Severe (3), 4 Very severe (4).

## Scoring and interpretation

Rate each of the 14 items 0 (not present) to 4 (very severe) from the interview. The scorer sums them for a 0 to 56 total.

Bands vary across sources. A common convention: 0 to 7 no or minimal anxiety, 8 to 14 mild, 15 to 23 moderate, and 24 or above severe. Use the total to track change over time.

| Score | Interpretation        |
| ----- | --------------------- |
| 0–7   | No or minimal anxiety |
| 8–14  | Mild                  |
| 15–23 | Moderate              |
| 24+   | Severe                |

Clinician-rated. Severity bands vary across sources; state the convention you use.

## Score it with AI

A ready-made prompt that turns any AI assistant into a scorer for the HAM-A. Paste it in, add the client's de-identified responses, and it computes the score and interpretation. Copy it, or download it to save as a reusable prompt.

1. 1 Copy the prompt below, or download it as a file.
2. 2 Open your AI assistant (Claude, ChatGPT, Gemini, or any LLM).
3. 3 Paste the prompt, then add the client's de-identified responses.
4. 4 Review the score and interpretation before you use them.

You are a careful scoring assistant for the Hamilton Anxiety Rating Scale (HAM-A), helping a qualified professional. You are a scoring aid, not a clinician: you do not diagnose or recommend treatment.

Ground rules:
- Use ONLY the items, response options and cut-offs given below as the source of truth. Do not rely on any version of this scale from memory; scales have variants and remembered items, scoring or cut-offs may be wrong.
- If anything I paste could identify a client, stop and ask me to de-identify it before scoring.
- Never guess, impute, average, or fill in a missing or unclear response.

Scale: clinician-rated measure, 14 items.
Each item is scored: 0 = 0 Not present; 1 = 1 Mild; 2 = 2 Moderate; 3 = 3 Severe; 4 = 4 Very severe.

Items:
1. Anxious mood (worry, anticipation of the worst)
2. Tension (startle, fatigability, inability to relax)
3. Fears (of the dark, strangers, being alone, crowds)
4. Insomnia (difficulty falling asleep, broken sleep, fatigue on waking)
5. Intellectual (difficulty concentrating, poor memory)
6. Depressed mood (loss of interest, low mood, diurnal variation)
7. Somatic — muscular (aches, stiffness, twitching, grinding teeth)
8. Somatic — sensory (tinnitus, blurred vision, hot and cold flushes)
9. Cardiovascular symptoms (palpitations, chest pain, throbbing)
10. Respiratory symptoms (chest pressure, choking, shortness of breath)
11. Gastrointestinal symptoms (difficulty swallowing, pain, nausea)
12. Genitourinary symptoms (frequency, urgency, loss of libido)
13. Autonomic symptoms (dry mouth, flushing, sweating, giddiness)
14. Behaviour at interview (fidgeting, tremor, restlessness)

Interpretation (ranges are inclusive; work out from these bands whether a higher score means more or less of the construct):
- Total 0 to 56: 0–7 No or minimal anxiety; 8–14 Mild; 15–23 Moderate; 24+ Severe.

When I give the client's de-identified responses, work in this order:
1. Parse them as item → value and restate the table so I can check it. If I give option labels, the client's words, or a finer scale than the options above, map each to the listed values and show the mapping.
2. Validate before scoring: confirm there are exactly 14 responses, each within its allowed range. If any are missing, extra, duplicated, out of range, or ambiguous, STOP and tell me what is wrong. Do not score a partial or invalid set.
3. Show your work: list the value used for each item (after any reverse-scoring), then add them explicitly. Add them to reach the total. Use only the numbers above.
4. Report, in this order:
   - the total score;
   - the severity band, quoting the exact range it falls in;
   - one or two sentences on what the score means on this scale;
   - this caveat: Clinician-rated. Severity bands vary across sources; state the convention you use.
   - a reminder that the HAM-A is a screening or rating aid, not a diagnosis, to be read within a full clinical assessment.
5. Re-check the arithmetic before finalising, and do not add a diagnosis, formulation or treatment plan unless I ask separately.

Here are the de-identified responses:

Copy prompt Download as .md

Before you rely on the score

* **Check the maths yourself.** AI assistants can still add up wrong or misapply a rule. The prompt makes the assistant show each item's value and the sum, so glance over that working, and re-total anything you will act on.
* **Confirm it used this scale.** Check that the items, response values, reverse-scoring and cut-offs it used match this page, not a different or outdated version the model recalled.
* **Watch for missing or odd inputs.** The prompt is told to stop rather than guess a missing or out-of-range response. If it scores anyway, treat the result as unreliable and re-check your inputs.
* **Act on critical items regardless of the total.** Respond to risk indicators, such as a self-harm item, on their own merit, even when the overall score looks low.
* **De-identify first, every time.** The assistant runs in your own account, outside ElloMind. Never enter a client's name or identifying details.
* **It is a screening aid, not the decision.** The score supports your clinical judgement within a full assessment. It does not diagnose, and it does not decide.

## Use the score in your notes

Take the score into a de-identified write-up with one of the free AI tools.

[Documentation Progress note (SOAP, DAP, BIRP)](/ai-tools-for-psychologists/progress-note-writer/) [Treatment planning Treatment plan (SMART goals)](/ai-tools-for-psychologists/treatment-plan/)

## Citation and sources

Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32(1), 50-55.

The HAM-A is in the public domain.

* [Hamilton Anxiety Rating Scale (overview)](https://en.wikipedia.org/wiki/Hamilton%5FAnxiety%5FRating%5FScale)  — Wikipedia

Want a version a client can fill in themselves? Point them to [the anxiety self-check for clients](/tools/anxiety/).

## Frequently asked questions

Who completes the HAM-A? + 

The clinician, after an interview. It is a clinician-rated scale, unlike the self-report GAD-7.

What HAM-A score indicates severe anxiety? + 

By a common convention, 24 or above indicates severe anxiety, with 0 to 7 minimal, 8 to 14 mild and 15 to 23 moderate. Thresholds vary across sources.

Is the HAM-A free to use? + 

Yes. The Hamilton Anxiety Rating Scale is in the public domain.

Does ElloMind see the client's data? + 

No. The prompt runs in your own AI assistant, and ElloMind never sees it. De-identify client information first.

## More scales

[Depression Patient Health Questionnaire-9 (PHQ-9)](/ai-tools-for-psychologists/scales/phq-9-depression-scale/) [Anxiety Generalised Anxiety Disorder-7 (GAD-7)](/ai-tools-for-psychologists/scales/gad-7-anxiety-scale/) [Depression · Anxiety · Stress Depression Anxiety Stress Scales (DASS-21)](/ai-tools-for-psychologists/scales/dass-21/) [Depression Hamilton Depression Rating Scale (HAM-D)](/ai-tools-for-psychologists/scales/hamilton-depression-rating-scale/)

A screening and rating aid for qualified professionals, not a diagnosis or a substitute for clinical judgement. Interpret every score within a full assessment. Never paste identifiable client data into a general AI assistant. If a client is in crisis, contact a [crisis helpline](/crisis-helpline/) right away.

[Back to all scales](/ai-tools-for-psychologists/scales/)