psychiatry

Brief Psychiatric Rating Scale (BPRS)

18-item clinician-administered scale assessing psychiatric symptoms in patients with major mental illness, particularly schizophrenia. Each item 1–7. Total 18–126. Widely used in clinical trials and acute settings.

Somatic concern — degree of concern over present bodily health*

Anxiety — worry, fear, or over-concern for present or future*

Emotional withdrawal — deficiency in relating to interviewer and situation*

Conceptual disorganisation — degree of speech disorganisation*

Guilt feelings — over-concern with past behaviour*

Tension — overt physical manifestations of tension and anxiety*

Mannerisms and posturing — unusual motor behaviour*

Grandiosity — exaggerated self-opinion, superiority, special mission*

Depressive mood — despondency in mood and hopelessness*

Hostility — animosity, contempt, belligerence, disdain*

Suspiciousness — belief that others bear ill will*

Hallucinatory behaviour — perceptions without normal external stimuli*

Motor retardation — slowing of movements and speech*

Uncooperativeness — resistance to instructions or interviews*

Unusual thought content — unusual, odd, strange or bizarre thought content*

Blunted affect — reduced emotional tone, reduced expression*

Excitement — heightened emotional tone; increased reactivity*

Disorientation — confusion or lack of proper association for person, place, or time*

Score interpretation

Below 'Mildly Ill' (BPRS < 31) 18–30

BPRS 18–30 — below the score linked to CGI 'mildly ill'

→ Outpatient management; optimise antipsychotic; psychotherapy (CBT for psychosis); close follow-up; consider community mental health team

Mildly Ill (≈ CGI 3) 31–40

BPRS 31–40 — about CGI 'mildly ill'

→ Outpatient management; optimise antipsychotic; psychotherapy (CBT for psychosis); close follow-up; consider community mental health team

Moderately Ill (≈ CGI 4) 41–52

BPRS 41–52 — about CGI 'moderately ill'

→ Consider antipsychotic dose review or medication change; regular psychiatric review; psychosocial interventions; assess need for crisis resolution or home treatment team

Markedly Ill or Worse (≈ CGI ≥ 5) 53–126

BPRS ≥ 53 — about CGI 'markedly ill' or worse

→ Urgent psychiatric assessment; inpatient admission consideration; assess risk (suicide, homicide, vulnerability); clozapine if treatment-resistant; MDT care planning

Interpretation bands for the BPRS. Apply clinical judgement and local guidance.

References

Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep. 1962;10:799–812.
Leucht S, et al. Clinical implications of Brief Psychiatric Rating Scale scores. Br J Psychiatry. 2005;187:366–371.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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