[7] The questionnaire is designed for adults and is used to rate the severity of their depression by probing mood, feelings of guilt, suicide ideation, insomnia, agitation or retardation, anxiety, weight loss, and somatic symptoms.
The HRSD has been criticized for use in clinical practice as it places more emphasis on insomnia than on feelings of hopelessness, self-destructive thoughts, suicidal cognitions and actions.
[10] The original 1960 version contained 17 items (HDRS-17), but four other questions not added to the total score were used to provide additional clinical information.
[11] Questions 18–20 may be recorded to give further information about the depression (such as whether diurnal variation or paranoid symptoms are present), but are not part of the scale.
[17] The UK National Institute for Health & Clinical Excellence has specified the following "levels of depression" based on the 17-item HRSD.