[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-ymrs":3,"all-assessments-nav":171,"related-assessments-query":851},{"id":4,"title":5,"body":6,"category":86,"categoryTitle":87,"clinicalCitations":88,"copyright":86,"description":101,"disclaimer":86,"downloadLink":86,"extension":102,"faqs":103,"featured":116,"i18nReady":116,"icon":86,"interpreter":117,"lastReviewed":148,"meta":149,"navigation":150,"path":151,"permissionsNote":86,"published":116,"recommendedFrequency":86,"relatedCodes":86,"relatedConditions":86,"reviewedBy":86,"seo":152,"slug":153,"stem":154,"summary":155,"takeaways":86,"timeline":156,"type":169,"usedToDiagnose":86,"__hash__":170},"assessments\u002Fassessments\u002Fymrs.md","Young Mania Rating Scale (YMRS): Scoring and Cutoffs",{"type":7,"value":8,"toc":73},"minimark",[9,13,18,21,24,27,32,35,38,42,45,49,52,56,59,63,66,70],[10,11,12],"p",{},"The YMRS is the criterion-standard 11-item clinician-administered scale for measuring manic symptom severity in bipolar disorder. Validated in 100+ clinical trials and translated into 40+ languages.",[14,15,17],"h2",{"id":16},"what-is-the-ymrs","What is the YMRS?",[10,19,20],{},"The YMRS (Young Mania Rating Scale) is an 11-item clinician-administered rating scale\nfor manic symptom severity developed by Young, Biggs, Ziegler, and Meyer (1978) at the Medical College\nof Virginia. It is the most widely used mania outcome measure in clinical trials and psychiatric practice\nworldwide, endorsed by major guidelines for assessing and tracking bipolar I mania.",[10,22,23],{},"Items cover the core domains of a manic episode: elevated mood, increased motor activity, sexual interest,\nreduced sleep, irritability, pressured speech, thought disorder, grandiose content, disruptive behavior,\nappearance changes, and impaired insight. Seven items are scored 0–4; four items (irritability, speech,\ncontent, and disruptive-aggressive behavior) are weighted and scored 0–8 due to their greater clinical\nsignificance. Total scores range from 0 to 60.",[10,25,26],{},"Although originally designed for clinician administration, the YMRS is increasingly used as a\nself-report (patient-rated) measure in clinical research settings. Patient-rated versions show\nacceptable convergent validity with clinician-rated scores, particularly for mild-to-moderate mania.",[28,29,31],"h3",{"id":30},"clinician-administered-tool","Clinician-Administered Tool",[10,33,34],{},"The YMRS is designed for clinician administration and requires clinical judgment for accurate scoring - particularly for items like thought disorder, content (delusions\u002Fhallucinations), and disruptive-aggressive behavior. Each item is rated over the past 48 hours (or since last assessment). Items 5, 6, 8, and 9 are weighted double (scored 0-8; remaining items 0-4). Score range: 0-60.",[10,36,37],{},"Educational and training purposes only. Not a substitute for trained clinician assessment.",[28,39,41],{"id":40},"ymrs-scoring-severity-levels","YMRS Scoring & Severity Levels",[10,43,44],{},"Total score = sum of all 11 items (items 5, 6, 8, 9 scored 0-8; remaining items 0-4). Score range: 0-60.",[28,46,48],{"id":47},"minimum-clinically-important-difference-mcid","Minimum Clinically Important Difference (MCID)",[10,50,51],{},"A change of ≥5–6 points on the YMRS is generally considered clinically meaningful in\ntreatment trials. Response is often defined as ≥50% reduction from baseline; remission\nas a score ≤12. These thresholds vary by study protocol and clinical context.",[14,53,55],{"id":54},"ymrs-item-structure","YMRS Item Structure",[10,57,58],{},"The YMRS covers 11 symptom domains. Four items are weighted double (scored 0–8) to reflect\ntheir clinical importance in distinguishing mania severity.",[14,60,62],{"id":61},"ymrs-vs-mdq-for-bipolar-assessment","YMRS vs MDQ for Bipolar Assessment",[10,64,65],{},"The YMRS and MDQ serve different purposes in bipolar disorder assessment, one measures\ncurrent mania severity, the other screens for lifetime bipolar disorder history.",[14,67,69],{"id":68},"automate-ymrs-in-your-practice","Automate YMRS in Your Practice",[10,71,72],{},"HiBoop supports digital YMRS administration with automated scoring, severity\ntracking over time, and integration with your clinical workflow.",{"title":74,"searchDepth":75,"depth":75,"links":76},"",3,[77,83,84,85],{"id":16,"depth":78,"text":17,"children":79},2,[80,81,82],{"id":30,"depth":75,"text":31},{"id":40,"depth":75,"text":41},{"id":47,"depth":75,"text":48},{"id":54,"depth":78,"text":55},{"id":61,"depth":78,"text":62},{"id":68,"depth":78,"text":69},null,"Bipolar Disorder",[89,92,95,98],{"text":90,"link":91},"Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133(5):429-435.","https:\u002F\u002Fdoi.org\u002F10.1192\u002Fbjp.133.5.429",{"text":93,"link":94},"Patel NC, Patrick DM, Youngstrom EA, Strakowski SM, DelBello MP. Response and remission in adolescent mania: signal detection analyses of the Young Mania Rating Scale. J Am Acad Child Adolesc Psychiatry. 2007;46(5):628-635.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F17450054\u002F",{"text":96,"link":97},"Samara MT, Levine SZ, Leucht S. Linkage of Young Mania Rating Scale to Clinical Global Impression Scale to Enhance Utility in Clinical Practice and Research Trials. Pharmacopsychiatry. 2023;56(1):18-24.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F35896419\u002F",{"text":99,"link":100},"Lukasiewicz M, Gerard S, Besnard A, et al. Young Mania Rating Scale: how to interpret the numbers? Determination of a severity threshold and of the minimal clinically significant difference in the EMBLEM cohort. Int J Methods Psychiatr Res. 2013;22(1):46-58.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F23526724\u002F","YMRS (Young Mania Rating Scale): 11-item clinician-administered scale for manic episode severity in bipolar disorder. Scoring 0–60, severity cutoffs, and remission thresholds.","md",[104,107,110,113],{"question":105,"answer":106},"Is the YMRS clinician-administered or a self-report measure?","The YMRS is a clinician-administered rating scale. Accurate scoring of several items — such as thought disorder, grandiose content, and disruptive-aggressive behaviour — requires clinical judgment that cannot be reliably replaced by patient self-report. Self-report adaptations exist in the research literature but are not the standard administration format.",{"question":108,"answer":109},"What YMRS score indicates remission from mania?","A total score of ≤12 is the most widely cited threshold for remission, supported by signal detection analyses comparing YMRS scores against clinician global impression ratings. Some protocols use ≤8 as a stricter criterion. These thresholds are outcome conventions used in clinical trials and should be interpreted within the broader clinical picture.",{"question":111,"answer":112},"How is the YMRS scored?","Eleven items are rated over the preceding 48 hours. Seven items are scored on a 0–4 scale. Four items — irritability, speech, thought content, and disruptive-aggressive behaviour — are weighted and scored 0–8 to reflect their greater clinical significance in distinguishing mania severity. Total scores range from 0 to 60.",{"question":114,"answer":115},"Can the YMRS be used to diagnose bipolar disorder?","No. The YMRS measures the current severity of manic symptoms; it does not provide a diagnosis of bipolar disorder or any other condition. Diagnosis requires comprehensive clinical evaluation according to established diagnostic criteria. The YMRS is used to track symptom severity over time and to assess treatment response.",false,{"heading":118,"scaleLabel":119,"min":120,"max":121,"start":122,"note":123,"source":124,"bands":125},"YMRS Score Interpreter","Total score",0,60,6,"11 items; items 5, 6, 8, 9 scored 0–8 (double-weighted); remaining items 0–4. Higher scores indicate greater manic symptom severity. Clinician-administered over the preceding 48 hours.","Samara MT, Levine SZ, Leucht S. Pharmacopsychiatry. 2023;56(1):18–24. YMRS–CGI-S equipercentile linkage (N=2,988 across 8 randomized trials). Score anchors correspond to CGI-S severity levels. Educational reference only — not a diagnostic tool.",[126,131,135,140,144],{"min":127,"label":128,"level":129,"note":130},40,"Extremely severe","error","Corresponds to 'severely to most extremely ill' on the CGI-S. Scores in this range were associated with the most impaired patients across 8 randomized controlled trials.",{"min":132,"label":133,"level":129,"note":134},30,"Markedly severe","Corresponds to 'markedly ill' on the CGI-S. Typical range associated with acute manic episodes requiring intensive treatment.",{"min":136,"label":137,"level":138,"note":139},20,"Moderate","warning","Corresponds to 'moderately ill' on the CGI-S. A score of 20 is the common entry threshold for acute mania trials (Lukasiewicz et al., 2013).",{"min":141,"label":142,"level":138,"note":143},12,"Mild","Corresponds to 'mildly ill' on the CGI-S. A score ≤12 is the widely cited remission threshold in clinical trials (Patel et al., 2007).",{"min":120,"label":145,"level":146,"note":147},"Minimal \u002F remission range","success","Scores below the remission threshold. Persistent low-level symptoms may still warrant clinical monitoring.","2026-06-03",{},true,"\u002Fassessments\u002Fymrs",{"title":5,"description":101},"ymrs","assessments\u002Fymrs","11-item clinician-rated scale measuring manic episode severity. Score 0–60; ≤11 minimal\u002Fremission, 12–19 mild, 20–29 moderate, 30–39 markedly severe, ≥40 extremely severe (CGI-S linked, Samara et al. 2023). Criterion-standard outcome measure in bipolar disorder treatment.",[157,160,163,166],{"year":158,"label":159},"1978","Original YMRS published by Young, Biggs, Ziegler & Meyer — 11-item clinician-rated scale validated in 70 inpatients at the Medical College of Virginia.",{"year":161,"label":162},"2007","Signal detection analyses (Patel et al.) confirmed ≤12 remission and ≥50%–55% reduction as optimal response\u002Fremission thresholds in adolescent populations.",{"year":164,"label":165},"2013","EMBLEM cohort study (Lukasiewicz et al., N=3,459) established a severity threshold of 25 and a minimal clinically significant difference of 6.6 points.",{"year":167,"label":168},"2023","Equipercentile linkage to CGI-S (Samara, Levine & Leucht, N=2,988) provided clinically interpretable score anchors for use in practice and trial 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