brief psychiatric rating scale

Introduction

Takes 18 minutes by trained interviewer.

Indications

• rapid assessment of global psychiatric symptoms especially sutied to evaluation of clinical change

Methods

16 item 7-point ordered category rating scale

Questions are completed in 2-3 minutes following the interview

Inter-rater reliability correlation 0.56-0.87

Scale: (for each item)

• Not present
• Very mild
• Mild
• Moderate
• Moderate, severe
• Severe
• Extremely severe

Procedure

• Somatic concern
  • degree of concern over present bodily health
  • rate the degree to which physical health is perceived as a problem by the patient, whether complaints have a realistic component or not
• Anxiety
  • worry, fear or over-concern for present or future
  • rate soley on the basis of verbal report of patient's own subjective feelings
  • do not infer anxiety form physical signs or from neurotic defense mechanisms
• Emotional withdrawal*
  • deficiency in relating to the interviewer & the interview
  • rate only degree to which the patient gives the impression of failing to be in emotional contact with other people in the interview situation
• Conceptual disorganization
  • degree to which the thought processes are confused, disconnected or disorganized
  • rate on the basis of integration of the speech; do not rate on the basis of patient's subjective impression of his/her own level of functioning
• Guilt feelings
  • over-concern or remorse for past behavior
  • rate on the basis of patient's subjective experiences or guilt
  • do not infer guilt feelings from depression, anxiety or neurotic defenses
• Tension*
  • physical & motor manifestations of tension, nervousness, & heightened vigilence
  • rate soly on the basis of physical signs & motor behavior, not on the bases of subjective experiences of tension reported by the patient
• Mannerisms & posturing*
  • unusual & unnatural motor behavior
  • rate only abnormality of movements, not simple heightened motor activity
• Grandiosity
  • exaggerated self-opinion, conviction of unusual abilities or powers
  • rate only on the basis of patient's statements about his/her relation with others, not on the basis of demeanor during the interview
• Depressive mood
  • despondency in mood, sadness
  • rate only the degree of despondency
  • do not rate on the basis of inference from psychomotor retardation & somatic complaints
• Hostility
  • animosity, contempt, belligerence, disdain for other people outside the interview
  • rate solely on the basis of the verbal report of feelings & actions of the patient towards others
  • do not infer hostility from neurotic defenses, anxiety or somatic complaints
• Suspiciousness
  • belief (delusional or otherwise) that others have or have had malicious or discrimatory intent toward the patient
  • rate on the basis of verbal report
  • rate only those suspicions which are current whether they concern past or present circumstances
• Hallucinatory behavior
  • perceptions without corresponding normal external stimuli
  • rate only experiences with are reported to have occurred within the last week & which are described distinctly different from thought or imagery of normal people
• Motor retardation*
  • reduction in energy level evidenced by slowed movements & speech, reduced body tone, decreased number of movements
  • rate on the basis of observed behavior of the patient
  • do not rate on the basis of the patient's subjective impression of his/her energy level
• Uncooperativeness*
  • evidence of resistance, unfriendliness, resentment, & lack of readiness to cooperate with the interviewer
  • rate only on the basis of the patient's attitude & responses to the interviewer & interview
  • do not rate on the basis of reported resentment of uncooperativeness outside the interview
• Unusual thought process
  • unusual, odd, strange or bizarre thought content
  • rate the degree of unusualness, not the degree of disorganization of thought processes
• Blunted affect
  • reduced emotional tone
  • apparent lack of normal feeling or involvement

* Ratings are divided into those based on

• *observation of the patient (tension, emotional withdrawal, mannnerisms & posturing, motor retardation, uncooperativeness)
• all others based on verbal report

More general terms

• numerical rating scale (NRS)