Also called the Bech–Rafaelsen Mania Rating Scale (BRMRS)
The Bech–Rafaelsen scale is like a tool to measure how severe the symptoms are in people living with bipolar disorder 🎭.
It evaluates different aspects like mood 😊, energy ⚡, behavior, and cognition 🧠. The scores for each section are added up to get a total score reflecting the overall severity 😕. The higher the score, the more intense the symptoms.
In short, the Bech–Rafaelsen scale is an important psychiatric tool to help evaluate symptom severity in people with bipolar disorder and adjust treatment accordingly 👍.
| 1. Motor Activity | |
|---|---|
| 0 | Normal motor activity, appropriate facial expression |
| 1 | Normal motor activity, appropriate facial expression |
| 2 | Moderately increased motor activity, e.g., expressive gestures |
| 3 | Excessive motor activity, mostly moving. Stands up several times during the interview. |
| 4 | Constantly active, cannot stay still even if told to do so. |
| 2. Verbal Activity | |
|---|---|
| 0 | Normal verbal activity |
| 1 | A bit talkative |
| 2 | Very talkative, no spontaneous pause during conversation |
| 3 | Hard to interrupt the person |
| 4 | Impossible to interrupt; monopolizes the conversation |
| 3. Flight of Ideas | |
|---|---|
| 0 | Coherent speech, no flight of ideas |
| 1 | Slightly fast descriptions or thoughts, but remains coherent |
| 2 | Occasionally struggles to stay on topic |
| 3 | Thought flow frequently disrupted, jumps from topic to topic |
| 4 | Impossible to follow the person’s train of thought |
| 4. Voice Volume | |
|---|---|
| 0 | Normal voice intensity |
| 1 | Speaks a bit loudly, but not disruptive |
| 2 | Voice clearly audible at a distance, somewhat loud |
| 3 | Yelling, loud voice, singing |
| 4 | Screams, shouts, or makes other loud noises |
| 5. Hostility | |
|---|---|
| 0 | No sign of impatience or hostility |
| 1 | Slightly impatient or irritable, but in control |
| 2 | Very impatient or irritable, intolerant of contradiction |
| 3 | Provocative, threatening, but can calm down |
| 4 | Obvious aggression or violence |
| 6. Mood | |
|---|---|
| 0 | Neutral mood |
| 1 | Slightly elevated, optimistic, appropriate mood |
| 2 | Moderately elevated, joking or laughing |
| 3 | Clearly elevated mood, exuberant behavior and speech |
| 4 | Extremely elevated and inappropriate to context |
| 7. Self-Esteem | |
|---|---|
| 0 | Normal self-esteem |
| 1 | Occasionally elevated self-esteem |
| 2 | Slightly elevated, boasts of unusual achievements |
| 3 | Unrealistic ideas, believes in extraordinary qualities |
| 4 | Grandiose ideas, resistant to criticism |
| 8. Social Contact | |
|---|---|
| 0 | Normal social contact |
| 1 | A bit overly familiar, slightly intrusive |
| 2 | Somewhat familiar and argumentative |
| 3 | Dominating, wants to lead everything, but still socially appropriate |
| 4 | Extremely dominating and manipulative, socially inappropriate |