title: The Hamilton Rating Scale for Depression: The making of a "gold standard" and the unmaking of a chronic illness, 1960-1980.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for the History of Science, Technology and Medicine, University of Manchester, Manchester, UK. michael.worboys@manchester.ac.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Worboys
mesh_terms: D002908:Chronic Disease; D003866:Depressive Disorder / Q000145:classification* / Q000188:drug therapy / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D011569:Psychiatric Status Rating Scales / Q000266:history* / Q000592:standards*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012720:Severity of Illness Index; D009626:Terminology as Topic
chemical_list: D011619:Psychotropic Drugs