Young Mania Rating Scale (YMRS)
Reference: Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability,
validity and sensitivity. Br J Psychiatry 1978; 133:429–35
Rating Clinician-rated
Administration time 10–20 minutes
Main purpose To assess severity of manic symptoms
Population Adults and adolescents with mania
Commentary
The YMRS is an 11-item clinician-rated scale designed to
assess severity of manic symptoms. The gold standard of
mania rating scales, the instrument is widely used in both
clinical and research settings. Information for assigning
scores is gained from the patient’s subjective reported
symptoms over the previous 48 hours and from clinical
observation during the interview. The scale is appropriate
both for assessing baseline severity of manic symptoms,
and response to treatment in patients with bipolar disor-
der type I and II. However, the YMRS does not assess
concomitant depressive symptoms and should be adminis-
tered in conjunction with a depression rating scale such as
the HDRS (see page 28) or the MADRS (see page 41) in
patients with concomitant symptoms of depression or
those experiencing a mixed episode.
Scoring
Four of the YMRS items are rated on a 0–8 scale, with
the remaining 5 items being rated on a 0–4 scale. Clear
anchor-points are provided to help the clinician determine
severity. A score of ≤12 indicates remission of symptoms.
Versions
A parent version of the YMRS has been produced; the scale
has been translated into other languages including Spanish
and Turkish, but the Royal College of Psychiatrists does
not hold a record of currently available translations.
Additional references
Gracious BL, Youngstrom EA, Findling RL, Calabrese
JR. Discriminative validity of a parent version of the
Young Mania Rating Scale. J Am Acad Child Adolesc
Psychiatry 2002; 41(11):1350–9.
Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea
JM, Benabarre A, Torrent C, Comes M, Corbella B,
Parramon G, Corominas J. A randomized trial on the
efficacy of group psychoeducation in the prophylaxis of
recurrences in bipolar patients whose disease is in
remission. Arch Gen Psychiatry 2003; 60(4):402–7.
Tohen M, Goldberg JF, Gonzalez-Pinto Arrillaga AM,
Azorin JM, Vieta E, Hardy-Bayle MC, Lawson WB,
Emsley RA, Zhang F, Baker RW, Risser RC, Namjoshi
MA, Evans AR, Breier A. A 12-week, double-blind
comparison of olanzapine vs haloperidol in the
treatment of acute mania. Arch Gen Psychiatry 2003;
60(12):1218–26.
Address for correspondence
The Royal College of Psychiatrists
The British Journal of Psychiatry
17 Belgrave Square, London SW1X 8PG, UK
Telephone: +44 (20) 7235 2351
Email: publications@rcpsych.ac.uk
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 Young Mania Rating Scale (YMRS)

Enter the appropriate score which best characterizes the subject for each item.

Item Explanation

1. Elevated mood 0 absent

1 mildly or possibly increased on questioning
2 definite subjective elevation: optimistic, self-confident; cheerful; appropriate to content
3 elevated, inappropriate to content; humorous
4 euphoric, inappropriate laughter singing
2. Increased motor activity-energy 0 absent
1 subjectively increased
2 animated; gestures increased
3 excessive energy; hyperactive at times; restless (can be calmed)
4 motor excitement; continues hyperactivity (cannot be calmed)
3. Sexual interest 0 normal; not increased
1 mildly or possibly increased
2 definite subjective increase on questioning
3 spontaneous sexual content; elaborates on sexual matters; hypersexual by self-report
4 overt sexual acts (toward subjects, staff, or interviewer)
4. Sleep 0 reports no decrease in sleep
1 sleeping less than normal amount by up to one hour
2 sleeping less than normal by more than one hour
3 reports decreased need for sleep
4 denies need for sleep
5. Irritability 0 absent
2 subjectively increased
4 irritable at times during interview; recent episodes of anger or annoyance on ward
6 frequently irritable during interview; short, curt throughout
8 hostile, uncooperative; interview impossible
6. Speech (rate and amount) 0 no increase
2 feels talkative
4 increased rate or amount at times, verbose at times
6 push; consistently increased rate and amount; difficult to interpret
8 pressured; uninterruptible; continuous speech
7. Language-thought disorder 0 absent
1 circumstantial; mild distractibility; quick thoughts
2 distractible; loses goal of thought; changes topics frequently; racing thoughts
3 flight of ideas; tangentiality; difficult to follow; rhyming; echolalia
4 incoherent; communication impossible
8. Content 0 normal
2 questionable plans, new interests
4 special project(s); hyperreligious
6 grandiose or paranoid ideas; ideas of reference
8 delusions; hallucinations
9. Disruptive-aggressive behaviour 0 absent, cooperative
2 sarcastic; loud at times, guarded
4 demanding; threats on ward
6 threatens interviewer shouting; interview difficult
8 assaultive; destructive; interview impossible
10. Appearance 0 appropriate dress and grooming
1 minimally unkempt
2 poorly groomed; moderately disheveled; overdressed
3 disheveled; partly clothed; garish make-up
4 completely unkempt; decorated; bizarre garb
11. Insight 0 present; admits illness; agrees with need for treatment
1 possibly ill
2 admits behaviour change, but denies illness
3 admits possible change in behaviour, but denies illness
4 denies any behaviour change

Reproduced from Young RC, Biggs JT, Ziegler VE, Meyer DA. Br J Psychiatry 1978; 133:429–35 with permission from the Royal College of
Psychiatrists.

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