The Hamilton Rating Scale for Depression: The making of a "gold standard" and the unmaking of a chronic illness, 1960-1980

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    Abstract

    Objectives: To show why and how the Hamilton Rating Scale for Depression became the Gold Standard for assessing therapies from the mid-1960s and how it was used to frame depression as a short-term and curable illness rather than a chronic one. Methods: My approach is that of the social construction of knowledge, identifying the interests, institutional contexts and practices that produce knowledge claims and then mapping the social processes of their circulation, validation and acceptance. Results: The circulation and validation of Hamilton Rating Scale for Depression was relatively slow and it became a Gold Standard from below, from an emerging consensus amongst psychiatrists undertaking clinical trials for depression, which from the 1960s were principally with psychopharmaceuticals for short-term illness. Hamilton Rating Scale for Depression, drug trials and the construction of depression as non-chronic were mutually constituted. Discussion: Hamilton Rating Scale for Depression framed depression and its sufferers in new ways, leading psychiatrists to understand illness as a treatable episode, rather than a life course condition. As such, Hamilton Rating Scale for Depression served the interests of psychiatrists and psychiatry in its new era of drug therapy outside the mental hospital. However, Hamilton Rating Scale for Depression was a strange kind of standard, being quite non-standard in the widely varying ways it was used and the meanings given to its findings. © 2012 The Author(s).
    Original languageEnglish
    Pages (from-to)202-219
    Number of pages17
    JournalChronic illness
    Volume9
    Issue number3
    DOIs
    Publication statusPublished - Sept 2013

    Keywords

    • chronic illness
    • clinical scales
    • Depression
    • psychopharmaceuticals
    • standards

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