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Brief Psychiatric Rating Scale (BPRS)

Instructions

The Brief Psychiatric Rating Scale (BPRS) is a clinician-rated instrument used to assess the severity of psychiatric symptoms. Rate each item on a scale from 1 (not present) to 7 (extremely severe) based on the patient's condition over the past week. For each item, circle the number that best represents the severity of the symptom.

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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 basis or not.

Anxiety

Worry, fear, or over-concern for present or future. Rate solely on the basis of verbal report of patient's own subjective experiences. Do not infer anxiety from physical signs or from neurotic defense mechanisms.

Depression

Deficiency in relating to the interviewer and to the interview situation. Rate only the degree to which the patient gives the impression of failing to be in emotional contact with other people in the interview situation.

Hostility

Degree to which the thought processes are confused, disconnected, or disorganized. Rate on the basis of integration of the verbal products of the patient; do not rate on the basis of the patient's subjective impression of his or her own level of functioning.

Paranoia

Over-concern or remorse for past behavior. Rate on the basis of the patient's subjective experiences of guilt as evidenced by verbal report with appropriate affect; do not infer guilt feelings from depression, anxiety, or neurotic defenses.

Tension

Physical and motor manifestations of tension, "nervousness," and heightened activation level. Tension should be rated solely on the basis of physical signs and motor behavior and not on the basis of subjective experiences of tension reported by the patient.

Mannerisms and Posturing

Unusual and unnatural motor behavior which causes certain mental patients to stand out in a crowd of normal people. Rate only abnormality of movements; do not rate simple heightened motor activity here.

Grandiosity

Exaggerated self-opinion, conviction of unusual ability or powers. Rate only on the basis of patient's statements about himself or self in relation to others, not on the basis of his demeanor in the interview situation.

Depressive Mood

Despondency in mood, sadness. Rate only degree of despondency; do not rate on the basis of inferences concerning depression based upon general retardation and somatic complaints.

Hostility

Animosity, contempt, belligerence, disdain for other people outside the interview situation. Rate solely on the basis of the verbal report of feelings and actions of the patient toward others; do not infer hostility from neurotic defenses, anxiety, or somatic complaints.

Suspiciousness

Belief (delusional or otherwise) that others have now, or have had in the past, malicious or discriminatory intent toward the patient. On the basis of verbal report, rate only those suspicions which are currently held whether they concern past or present circumstances.

Hallucinatory Behavior

Perceptions without normal external stimulus correspondence. Rate only those experiences which are reported to have occurred within the last week and which are described as distinctly different from the thought and imagery processes of normal people.

Motor Retardation

Reduction in energy level evidenced in slowed movements and speech, reduced body tone, decreased number of movements. Rate on the basis of observed behavior of the patient only; do not rate on the basis of patient's subjective impression of own energy level.

Uncooperativeness

Evidence of resistance, unfriendliness, resentment, and lack of readiness to cooperate with the interviewer. Rate only on the basis of the patient's attitude and responses to the interviewer and the interview situation; do not rate on the basis of reported resentment or uncooperativeness outside the interview situation.

Unusual Thought Content

Unusual, odd, strange, or bizarre thought content. Rate here the degree of unusualness, not the degree of disorganization of thought processes.

Blunted Affect

Reduced emotional tone, apparent lack of normal feeling or involvement.

Excitement

Heightened emotional tone, increased reactivity, agitation.

Disorientation

Confusion or lack of proper association for person, place, or time.

Self-neglect

Personal hygiene, appearance, and self-care below the usual standards for the patient and their environment.

Bizarre Behavior

Reports of behaviors which are unusual, bizarre, and not culturally normative (e.g., talking to self in public, hoarding garbage).

Elated Mood

Elevated mood, feeling "high" or euphoric, excessive optimism.

Motor Hyperactivity

Increase in energy level evidenced in more frequent movement and/or rapid speech.

Distractibility

Degree to which the patient is distracted by environmental stimuli during the interview.

Suicidality

Expressed desire, intent, or actions to harm or kill self.
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