What Is the Brief Psychiatric Rating Scale (BPRS)?

The Brief Psychiatric Rating Scale (BPRS) is one of several tools that help researchers study people with schizophrenia and related psychotic disorders. They use it to track changes in symptoms over time. You probably won’t come across this rating scale unless you’re part of a study or a clinical trial for a new type of treatment.

How Does It Work?

The doctor will ask you specific questions or look for certain behaviors. He’ll get a series of ratings based on your answers. That helps him track your progress.

The criteria have been redone several times since the BPRS was developed in the 1960s. The version most often used today includes 24 different symptom areas for doctors to evaluate, though some doctors use a shorter version with only 18 symptoms:

  1. Somatic concerns (concerns about your physical health)
  2. Anxiety
  3. Depression
  4. Suicidality (suicidal feelings or attempts)
  5. Guilt
  6. Hostility
  7. Elated mood
  8. Grandiosity (identifying as rich, famous, or having special powers)
  9. Suspiciousness
  10. Hallucinations
  11. Unusual thought content
  12. Bizarre behavior
  13. Self-neglect
  14. Disorientation
  15. Conceptual disorganization (confused, vague, or disconnected speech)
  16. Blunted affect (trouble expressing emotions)
  17. Emotional withdrawal
  18. Motor retardation (slow physical or emotional reactions)
  19. Tension
  20. Uncooperativeness
  21. Excitement
  22. Distractibility
  23. Motor hyperactivity (frequent movement or rapid speech)
  24. Mannerisms and posturing

Doctors rank the severity of each symptom using a scale of one to seven: A score of one means you don’t have that symptom. A seven means you do and it’s severe. Together, these ratings give doctors an idea about how much your condition affects you.

When doctors decide on these ratings, they consider how often you have the symptom and how much it affects your health and daily life. If the doctor can’t rate you for a specific symptom or symptoms, he can also choose a score of 0 or “NA” (not assessed) for these areas.

To complete the BPRS, the doctor will interview you for about 15 to 30 minutes. He’ll ask questions like:

  • How has your mood been recently?
  • Have you felt that life wasn’t worth living?
  • Have you heard any sounds, or people talking to you or about you, when there was no one around?”

Continued

Your doctor can assess some areas based on what he sees. He’ll check to see if your speech or actions are slow or weakened. He’ll gauge how tense you are, or if you have unusual or repeated mannerisms, like rocking, nodding, or grimacing.

Your total rating -- all 24 items added up -- isn’t as important as how you rank for different clusters of symptoms. The doctor may look at your combined rating for depression, anxiety, and guilt, compared with your score for hallucinations and bizarre behavior. This lets the doctor track how well treatment works to improve your symptoms.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on August 16, 2017

Sources

SOURCES:

Joseph Ventura, PhD, senior research psychologist, University of California, Los Angeles.

Psychiatry Research: “The Brief Psychiatric Rating Scale (version 4.0) factorial structure and its sensitivity in the treatment of outpatients with unipolar depression.”

Iowa Coalition on Mental Health & Aging: “Screening, Diagnostic Assessment and Interview Tools.”

International Journal of Methods in Psychiatric Research: “Training and quality assurance with the brief psychiatric rating scale: ‘The drift buster.’ ”

European Neuropsychopharmacology: “Impact of BPRS interview length on ratings reliability in a schizophrenia trial.”

Brown School of Public Health: “Brief Psychiatric Rating Scale (BPRS).”

Journal of Psychiatric Research: “Factor structure of the Brief Psychiatric Rating Scale -- Expanded (BPRS - E) in a large hospitalized sample.”

Journal of Clinical Psychiatry: “Suicidality and risk of suicide -- definition, drug safety concerns, and a necessary target for drug development: a consensus statement.”

American Family Physician: “Mental Status Examination in Primary Care: A Review.”

PLoS One: “Instruments Measuring Blunted Affect in Schizophrenia: A Systematic Review.”

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