YMRS: Young Mania Rating Scale

Rate on the basis of the patient’s report of the past 48 hours and behaviour observed during the interview. Items 5, 6, 8 and 9 are double-weighted (0–8) to compensate for poor cooperation in severely ill patients.

1. 1Elevated mood

   0Absent1Mildly or possibly increased on questioning2Definite subjective elevation; optimistic, self-confident, cheerful; appropriate to content3Elevated, inappropriate to content; humorous4Euphoric; inappropriate laughter; singing
2. 2Increased motor activity and energy

   0Absent1Subjectively increased2Animated; gestures increased3Excessive energy; hyperactive at times; restless (can be calmed)4Motor excitement; continuous hyperactivity (cannot be calmed)
3. 3Sexual interest

   0Normal; not increased1Mildly or possibly increased2Definite subjective increase on questioning3Spontaneous sexual content; elaborates on sexual matters; hypersexual by self-report4Overt sexual acts towards patients, staff or interviewer
4. 4Sleep

   0Reports no decrease in sleep1Sleeping less than normal amount by up to one hour2Sleeping less than normal by more than one hour3Reports decreased need for sleep4Denies need for sleep
5. 5Irritabilityscored 0–8

   0Absent2Subjectively increased4Irritable at times during interview; recent episodes of anger or annoyance on ward6Frequently irritable during interview; short, curt throughout8Hostile, uncooperative; interview impossible
6. 6Speech (rate and amount)scored 0–8

   0No increase2Feels talkative4Increased rate or amount at times; verbose at times6Push; consistently increased rate and amount; difficult to interrupt8Pressured; uninterruptible, continuous speech
7. 7Language and thought disorder

   0Absent1Circumstantial; mild distractibility; quick thoughts2Distractible; loses goal of thought; changes topics frequently; racing thoughts3Flight of ideas; tangentiality; difficult to follow; rhyming; echolalia4Incoherent; communication impossible
8. 8Contentscored 0–8

   0Normal2Questionable plans, new interests4Special project(s); hyper-religious6Grandiose or paranoid ideas; ideas of reference8Delusions; hallucinations
9. 9Disruptive or aggressive behaviourscored 0–8

   0Absent; cooperative2Sarcastic; loud at times; guarded4Demanding; threats on ward6Threatens interviewer; shouting; interview difficult8Assaultive; destructive; interview impossible
10. 10Appearance

    0Appropriate dress and grooming1Minimally unkempt2Poorly groomed; moderately dishevelled; overdressed3Dishevelled; partly clothed; garish make-up4Completely unkempt; decorated; bizarre garb
11. 11Insight

    0Present; admits illness; agrees with need for treatment1Possibly ill2Admits behaviour change, but denies illness3Admits possible change in behaviour, but denies illness4Denies any behaviour change