Young Mania Rating Scale
The Young Mania Rating Scale (YMRS), developed by R.C. Young in 1978, is an eleven-item multiple choice diagnostic questionnaire which psychiatrists use to measure the severity of manic episodes in children and young adults. The scale was originally developed for use in the evaluation of adult patients with bipolar disorder, but has since been modified for use in pediatric patients. A similar scale was then developed to allow clinicians to interview parents about their children's symptoms, in order to ascertain a better diagnosis of mania in children. This parent version (P-YMRS) can be completed by a parent or a teacher to determine whether a child should receive further evaluation from a psychologist or psychiatrist. Clinical studies have demonstrated the reliability and validity of the parent version of the scale, which has been found to provide “clinically meaningful information about mood disorders in youth." However, it should be noted that while the P-YMRS does succeed in identifying most cases of childhood bipolar disorder, it has an extremely high false positive rate.
Scoring and Interpretation
Each question refers to specific aspects of the child’s behavior and mood the parent has witnessed in the past 24 hours.
- For questions 1-4, 10, and 11: parents are asked to rate their child's behavior on a scale of 0 (the child did not experience or display the mood or behavior) to 4 (the child experienced or displayed the mood or behavior to a great degree)
- For questions 5-9: parents are asked to rate their child's behavior on a scale of 0 (the child did not experience or display the mood or behavior) to 8 (the child experienced or displayed the mood or behavior to a great degree)
The scores from each question are added together to form a total score ranging from 0 to 60, with higher scores indicating a greater severity of symptoms. Extremely high scores increase the risk of the child having bipolar disorder by a factor of 9, while extremely low scores decrease the risk by a factor of 10. A score of 13 or higher indicates a potential case of mania or hypomania, while a score of 21 or above indicates a probable case. The average score for children with mania is 25, while the average score for children with hypomania is 20.
- Full P-YMRS
- P-YMRS Instructions
- Diagnostic classification and rating scales used in psychiatry
- Young RC, Biggs JT, Ziegler VE, Meyer DA (Nov 1978). "A rating scale for mania: reliability, validity and sensitivity". Br J Psychiatry 133 (5): 429–35. doi:10.1192/bjp.133.5.429. PMID 728692.
- Gracious, BL; Youngstrom, EA; Findling, RL; Calabrese, JR (November 2002). "Discriminative validity of a parent version of the Young Mania Rating Scale.". Journal of the American Academy of Child and Adolescent Psychiatry 41 (11): 1350–9. PMID 12410078.
- Marchand, WR; Clark, SC; Wirth, L; Simon, C (March 2005). "Validity of the parent young mania rating scale in a community mental health setting.". Psychiatry (Edgmont (Pa. : Township)) 2 (3): 31–35. PMID 21179627.
- "Parent Version of the Young Mania Rating Scale (P-YMRS) Instructions." (PDF). HMSA. Retrieved 14 September 2015.
- "Parent Version of the Young Mania Rating Scale (P-YMRS)." (PDF). The Balanced Mind: Parent Network. Depression and Bipolar Support Alliance. Retrieved 14 September 2015.
- "Table of all screening tools and rating scales". School Psychiatry Program and MADI Resource Center. Massachusetts General Hospital. Retrieved 14 September 2015.
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