Brief Psychiatric Rating Scale

The Brief Psychiatric Rating Scale (BPRS) is a rating scale which a clinician or researcher may use to measure psychiatric symptoms such as depression, anxiety, hallucinations and unusual behaviour. The scale is one of the oldest, most widely used scales to measure psychotic symptoms and was first published in 1962.

History
The BPRS was initially developed by John E. Overall and Donald R. Gorham. It was created for the purpose of being able to quickly assess the patient’s psychiatric symptoms prior, during, or following a treatment. The items of the test were generated from conducting factor analysis on the Multidimensional Scale for Rating Psychiatric Patients and the Inpatient Multidimensional Psychiatric Scale. Sixteen factors were found from the analysis, which served as the building blocks for the BPRS. Later research in 1968 added two more factors to the BPRS, which were excitement and disorientation.

Test format
The BPRS consists of 18 items measuring the following factors:
 * (1) anxiety,
 * (2) emotional withdrawal,
 * (3) conceptual disorganization,
 * (4) guilt feelings,
 * (5) tension,
 * (6) mannerisms and posturing,
 * (7) grandiosity,
 * (8) depressive moods,
 * (9) hostility,
 * (10) suspiciousness,
 * (11) hallucinatory behavior,
 * (12) motor hyperactivity,
 * (13) uncooperativeness,
 * (14) unusual thought content,
 * (15) blunted affect,
 * (16) somatic concern,
 * (17) excitement, and
 * (18) disorientation.

It uses a seven-item Likert scale with the following values:
 * 1 = “not present”,
 * 2 = “very mild”,
 * 3 = “mild”,
 * 4 = “moderate”,
 * 5 = “moderately severe”,
 * 6 = “severe”,
 * 7 = “extremely severe”.

The test is administered in tandem with a series of interviews conducted by at least two clinicians to ensure interrater reliability of the assessment.

Usage
The BPRS is intended for use on adult psychiatric patients and has been validated for use in elderly populations. A version designed for children called the Brief Psychiatric Rating Scale Children was also developed by Overall and Betty Pfefferbaum, with different scale structures and factors.

Further development
An expanded version of the test was created in 1993 by D. Lukoff, Keith H. Nuechterlein, and Joseph Ventura.