(Ч ТБВПФЕ)

A Rating Scale for Mania:
Reliability, Validity and Sensitivity

Guide for Scoring -

The purpose of each item is to rate the severity of that abnormality in the patient. When several keys are given for a particular grade of severity the presence of only one is required to qualify for that rating.

The keys provided are guides. One can ignore the keys if that is necessary to indicate severity, although this should be the exception rather than the rule.

Scoring between the points given (whole or half points) is possible and encouraged after experience with the scale is acquired; this is particularly useful when severity of a particular item in a patient does not follow the progression indicated by the keys.

			 
Elevated Mood		 

• 0. Absent 1. Mildly or possibly increased on questioning 2. Desire subjective elevation; optimistic, self-confident; cheerful; appropriate to content 3. Elevated, inappropriate to content; humorous 4. Euphoric; inappropriate laughter; singing

Increased Motor Activity - Energy

• 0. Absent 1. Subjectively increased 2. Animated; gestures increased 3. Excessive energy; hyperactive at times, restless (can be calmed) 4. Motor excitement; continuous hyperactivity (cannot be calmed)

Sexual Interest

• 0. Normal; not increased 1. Mildly or possibly increased 2. Definite subjective increase on questioning 3. Spontaneous sexual content; elaborate on sexual matters; hypersexual by self-report 4. Overt sexual acts (toward patients, staff or interviewer

Sleep

• 0. Reports no decrease in sleep 1. Sleeping less than normal amount by up to one hour 2. Sleeping less than normal by more than one hour 3. Reports decreased need for sleep 4. Denies need for sleep

Irritability
 

• 0. Absent 2. Subjectively increased 4. Irritable at times during interview; recent episodes of anger or annoyance on ward 6. Frequently irritable during interview; short, curt throughout 8. Hostile, uncooperative; interview impossible

Speech (Rate and Amount)

• 0. No increase 2. Feels talkative 4. Increased rate or amount at times, verbose at times 6. Push; consistently increased rate and amount; difficult to interrupt 8. Pressured; uninterruptable, continuous speech

Language-Thought Disorder

• 0. Absent 1. Circumstantial; mild distractibility; quick thoughts 2. Distractible; loses goal of thought; changes topics frequently; racing thoughts 3. Flight of ideas; tangentiality; difficult to follow; rhyming; echolalia 4. Incoherent; communication impossible

Content

• 0. Normal 2. Questionable plans, new interests 4. Special project(s); hyperreligious 6. Grandiose or paranoid ideas; ideas of reference 8. Delusions; hallucinations

Disruptive-Aggressive Behavior

• 0. Absent, cooperative 2. Sarcastic; loud at times; guarded 4. Demanding; threats on ward 6. Threatens interviewer; shouting; interview difficult 8. Assaultive; destructive; interview impossible

Appearance 

• 0. Appropriate dress and grooming 1. Minimally unkempt 2. Poorly groomed; moderately disheveled; overdressed 3. Disheveled; partly clothed; garish makeup 4. Completely unkempt; decorated; bizarre garb

Insight

• 0. Present; admits illness; agrees with need for treatment 1. Possibly ill 2. Admits behavior change, but denies illness 3. Admits possible change in behavior, but denies illness 4. Denies any behavior change

Reference

Young RC, Biggs, JT, Ziegler VE, Meyer DA. A Rating Scale for Mania: Reliability, Validity and Sensitivity. Br J Psychiat. 1978;133:429-35.