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Psychometric properties of responses by clinicians and older adults to a 6-item Hebrew version of the Hamilton Depression Rating Scale (HAM-D6)

Yaacov G Bachner1*, Norm O’Rourke2, Margalit Goldfracht3, Per Bech4 and Liat Ayalon5

Author Affiliations

1 Department of Public Health and the Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 653, Beer-Sheva 84105, Israel

2 Faculty of Arts and Social Sciences, Simon Fraser University, Burnaby, (BC), Canada

3 Community Division, Clalit Health Services, Tel Aviv, Israel and Department of Family, Health Care, Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel

4 Department of Psychiatry, Frederiksborg General Hospital, Hilleord, Denmark

5 Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel

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BMC Psychiatry 2013, 13:2  doi:10.1186/1471-244X-13-2

Published: 3 January 2013



The Hamilton Depression Rating Scale (HAM-D) is commonly used as a screening instrument, as a continuous measure of change in depressive symptoms over time, and as a means to compare the relative efficacy of treatments. Among several abridged versions, the 6-item HAM-D6 is used most widely in large degree because of its good psychometric properties. The current study compares both self-report and clinician-rated versions of the Hebrew version of this scale.


A total of 153 Israelis 75 years of age on average participated in this study. The HAM-D6 was examined using confirmatory factor analytic (CFA) models separately for both patient and clinician responses.


Reponses to the HAM-D6 suggest that this instrument measures a unidimensional construct with each of the scales’ six items contributing significantly to the measurement. Comparisons between self-report and clinician versions indicate that responses do not significantly differ for 4 of the 6 items. Moreover, 100% sensitivity (and 91% specificity) was found between patient HAM-D6 responses and clinician diagnoses of depression.


These results indicate that the Hebrew HAM-D6 can be used to measure and screen for depressive symptoms among elderly patients.

Depression; Hamilton depression rating scale; Hebrew; Elderly