Manic Rating Scale

elevated mood

absent

0

mildly or possibly increased on questioning

1

definite subjective elevation; optimistic; self-confident; cheerful; appropriate to content

2

elevated; inappropriate to content; humorous

3

euphoric; inappropriate laughter; singing

4

increased motor activity and energy

absent

0

subjectively increased

1

animated; gestures increased

2

excessive energy; hyperactive at times; restless (can be calmed)

3

motor excitement; continuous hyperactivity (cannot be calmed)

4

sexual interest

normal; not increased

0

mildly or possibly increased

1

definite subjective increase on questioning

2

spontaneous sexual content; elaborates on sexual matters; hypersexual by self report

3

overt sexual acts (towards patients, staff or interviewer)

4

sleep

reports no decrease in sleep

0

sleeping less than normal amount by up to 1 hour

1

sleeping less than normal by more than 1 hour

2

reports decreased need for sleep

3

denies need for sleep

4

irritability

absent

0

subjectively increased

2

irritable at times during interview; recent episodes of anger or annoyance on ward

4

frequently irritable during interview; short, curt throughout

6

hostile; unco-operative; interview impossible

8

speech (rate and amount)

no increase

0

feels talkative

2

increased rate and amount at times; verbose at times

4

push; consistently increased rate and amount; difficult to interrupt

6

pressured; uninterruptible; continuous speech

8

language-thought disorder

absent

0

circumstantial; mild distractibility; quick thoughts

1

distractible; loses goal of thought; changes topics frequently; racing thoughts

2

flight of ideas; tangentiality; difficult to follow; rhyming; echolalia

3

content

normal

0

questionable plans, new interests

2

special projects; hyperreligious

4

grandiose or paranoid ideas; ideas of reference

6

delusions; hallucinations

8

disruptive-aggressive behavior

absent, co-operative

0

sarcastic; loud at times; guarded

2

demanding; threats on ward

4

threatens interviewer; shouting; interview difficult

6

assaultive; destructive; interview impossible

8

appearance

appropriate dress and grooming

0

minimally unkept

1

poorly groomed; moderately disheveled; overdressed

2

dishevelled; partly clothed; garish make-up

3

completely unkept; decorated; bizarre garb

4

insight

present; admits illness; agrees with need for treatment

0

admits that possibly ill

1

admits behavior change but denies illness

2

admits possible change in behavior but denies illness

3

denies any behavior change

4