Manic State Rating Scale

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Manic State Rating Scale

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About Manic State Rating Scale

Scale Name

Manic State Rating Scale

Author Details

Alan Beigel, Dennis L. Murphy, and William E. Bunney Jr.

Translation Availability

English

Background/Description

The Manic State Rating Scale (MSRS), developed by Alan Beigel, Dennis L. Murphy, and William E. Bunney Jr. in 1971, is a pioneering clinician-rated tool designed to assess the severity of manic symptoms in hospitalized patients with bipolar disorder or related conditions. Published in the Archives of General Psychiatry, the MSRS was created at the National Institute of Mental Health to provide a structured, reliable method for nurses and clinicians to quantify observable manic behaviors, addressing the need for objective measurement in psychiatric research. It remains a foundational instrument in the study of mania, influencing subsequent scales.

The MSRS comprises 26 items, each rated on two dimensions—frequency and intensity—using a 6-point scale (0 = “not observed” to 5 = “continuous/extreme”), yielding a total score range of 0 to 260. Items cover key manic features such as elevated mood, hyperactivity, irritability, and speech pressure, assessed through direct observation over a specified period (typically 24 hours). Taking about 15-20 minutes to complete, the MSRS is practical for inpatient settings, offering a detailed snapshot of mania severity. While primarily in English, its rigorous design has made it a reference point for mania assessment globally.

Administration, Scoring and Interpretation

  • Obtain the copy: Access the MSRS from its original publication in Beigel et al. (1971) via Archives of General Psychiatry or authorized psychiatric resources, ensuring proper training for observers.
  • Explain the purpose: Inform the clinical team that the scale measures manic symptom severity to monitor patient status and treatment response in a hospital setting.
  • Provide instructions: Instruct trained observers (e.g., nurses) to rate each of the 26 items based on patient behavior observed over a set period, scoring both frequency and intensity on the 6-point scale.
  • Approximate time: Allow approximately 15-20 minutes for observation synthesis and scoring, depending on familiarity with the tool and patient complexity.
  • Administer the scale: Conduct the assessment in an inpatient environment, systematically recording observations to ensure consistency across raters.

Reliability and Validity

The Manic State Rating Scale demonstrates robust psychometric properties, as detailed in Beigel et al. (1971). Inter-rater reliability is high, with correlation coefficients exceeding 0.90 among nursing team members for all items, reflecting strong agreement across trained observers. Test-retest reliability was not explicitly reported in the original study, but the scale’s consistency in stable inpatient settings suggests dependable repeated measures.

Validity is well-supported. Concurrent validity is evidenced by high correlations (r > 0.80) between MSRS item scores and independent global mania ratings by psychiatrists, as well as a nurse-completed manic symptom checklist, with 22 of 26 items showing significant alignment. Six items were identified as particularly sensitive to changes in mania severity, enhancing the scale’s practical utility. Its focus on observable behaviors ensures content validity for manic states, though its inpatient focus limits broader applicability. The MSRS remains a valid tool for detailed mania assessment in controlled settings.

Available Versions

26-Items

Reference

Beigel, A., Murphy, D. L., & Bunney, W. E. (1971). The manic-state rating scale: scale construction, reliability, and validityArchives of General Psychiatry25(3), 256-262.

Important Link

Scale File:

Frequently Asked Questions

What does the MSRS measure?
It measures the severity of manic symptoms in hospitalized patients.

How many items are in the MSRS?
It includes 26 items rated on frequency and intensity.

Who developed the MSRS?
It was developed by Alan Beigel, Dennis Murphy, and William Bunney Jr. in 1971.

How long does it take to complete the MSRS?
It takes about 15-20 minutes based on observation.

Who administers the MSRS?
Trained clinicians or nurses administer it in inpatient settings.

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