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Comparison of the Brief Psychiatric Rating Scale and the Brief Symptom Inventory.

General psychopathology rating scales have multiple uses and have been used extensively. These rating scales may be found in several forms including an interview procedure and self-report. The advantages of self-report measures, as well as their possible deficits, were discussed. Because there are so many varying kinds of rating scales, criteria were set forth as to how to evaluate scales. An interview with a rating scale, the Brief Psychiatric Rating Scale (BPRS), and a self-report measure, the Brief Symptom Inventory (BSI), were compared in this study. The BPRS has been widely used and has been evaluated as one of the very best rating scales. However, experienced raters and more time are needed to administer the BPRS. The BSI is highly evaluated as one of the best brief self-report measures and requires much less professional time. Both instruments have high reliability and validity. Correlations of the BPRS total score with the total scores on the BSI were significant, as were correlations of the depression, anxiety, and hostility subscales on each instrument. Therefore, either scale could be used for a brief assessment of overall symptomatology, depression, anxiety, and hostility. However, it is suggested that the subscales should be compared to other criteria to measure their convergent validity.

Adult↗

Comparative study of four evaluation criteria in a clinical trial with schizophrenic patients.

In order to compare the level of agreement between four evaluation criteria, data from an 18-month clinical trial with 181 schizophrenic patients were reanalyzed. In that study, assessments of the subjects were carried out with two psychiatric rating scales, Brief Psychiatric Rating Scale and Nurses' Observation Scale for Inpatient Evaluation (BPRS and NOSIE), and two clinical evaluations (psychiatrist and nurse). Results show that there was total agreement on the four outcome measures for only half of the subjects. After further analyses, we observed that the best agreement was between the two clinical assessments. The NOSIE had poor agreement with the other criteria and appeared less sensitive to moderate levels of improvement in the patients' clinical status. These results are discussed with respect to reliability and validity issues.

Adult↗

Psychopharmacological correlates of post-psychotic depression: a double-blind investigation of haloperidol vs thiothixene in outpatient schizophrenia.

A 24-week double-blind study was conducted to compare haloperidol and thiothixene for efficacy and safety in 46 schizophrenic outpatients. In addition to the standard psychiatric rating scales, Brief Psychiatric Rating Scale (BPRS), Nurses' Observation Scale for Inpatient Evaluation (NOSIE), and Evaluation of Social Functioning Rating (ESFR), two scales more sensitive to the incidence of treatment emergent depression were utilized. They were the Hamilton Depression Scale (HPRSD) and the Zung Self-rating Depression Scale (ZUNG). On the BPRS factors, haloperidol was significantly superior to thiothixene in Thought Disturbance and Hostility-Suspiciousness, and in Total symptomatology. Haloperidol was also significantly superior to thiothixene in Cognitive Disturbance on the HPRSD. Results of global evaluations suggested haloperidol produced slightly more rapid relief of symptoms than did thiothixene. The inclusion of the depression scales was useful in following patients who exhibited depressive symptoms; clinically significant depression was seen in 5 patients receiving haloperidol and 3 receiving thiothixene. A high incidence of akathisia in the thiothixene group was responsible for a statistically significant difference between groups in the number of central nervous system symptoms. Mean doses of test drugs were 17.5 mg/day for haloperidol an 31.8 mg/day for thiothixene. The study showed that haloperidol was equal to and in some parameters superior to thiothixene in producing improvement in the symptoms of psychosis.

Adolescent↗

The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale. Reliability, comparability, and predictive validity.

In a psychiatric rehabilitation study, 154 concurrent ratings were performed using the 30-item Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS). Although both instruments had excellent interrater reliability, the PANSS was consistently better: on the 18 symptom items the two instruments share, the PANSS had higher intraclass r's on 14; for the syndromes, the PANSS was higher than the BPRS on positive, negative, and total. Weighted Kappas comparing shared items revealed that most were not interchangeable, with only three coefficients in the excellent range. However, syndrome scale scores were very highly correlated and resulted in similar classification for negative schizophrenia. Ten of the 12 items of the PANSS not included in the BPRS had low zero-order correlations with BPRS items, which suggests that they measure symptoms distinct from those measured by the BPRS and should add to clinical predictive power. This proved true in our study of rehabilitation of patients with schizophrenia. PANSS symptom ratings explained up to 55% of the variance on seven measures of work performance, whereas the BPRS had lower predictive power on six of the seven measures. We concluded that the PANSS may be superior to the BPRS in clinical research on schizophrenia and that most BPRS items are not interchangeable with identically named PANSS items.

Adult↗

The relationship between discharge readiness inventory scales and the brief psychiatric rating scale.

OBJECTIVE: Important relationships exist between chronic psychiatric patients' symptoms of disorder and their readiness to be discharged from inpatient treatment. Behavioral rating scales can supplement clinical decision making by standardizing information about patients' functioning. The authors assessed whether two different behavioral measures described the same dimensions of disordered behavior in an older chronic patient population. METHODS: Multivariate correlation analysis (canonical analysis) was used to assess relationships between items on the Brief Psychiatric Rating Scale and the scales in the Discharge Readiness Inventory. RESULTS: Three significant correlation variates were found. The variates reflected patterns of positive psychiatric symptomatology with a low level of psychosocial competence, a low level of symptomatology with a low level of psychosocial competence, and paranoid symptomatology with a high level of psychosocial competence. CONCLUSIONS: The presence or absence of psychiatric symptomatology and possibly the type of symptomatology are relevant in assessing patients' readiness for discharge.

Activities of Daily Living↗

Prototypical profiles of the Brief Psychiatric Rating Scale.

Three prototypical profiles of the Brief Psychiatric Rating Scale (BPRS; Overall & Gorham, 1962) were isolated using a Q-type factor-analytic strategy with a sample of homeless men with mental illness (N=165). The 3 profiles--depressed, actively psychotic, and withdrawn--were used to study changes in BPRS profiles over time in a control group and a group that received assertive community treatment (ACT). Over2 time periods (inception to 12 months and 12-24 months), the 2 groups did not differ in terms of changes in profile shape, but they did differ in terms of changes in profile elevation. The ACT group evidenced a decrease in symptom severity during the last 12 months, whereas the control group showed an increase. Although changes in profile shape in both groups did occur, there was a significant tendency for the shape of the BPRS profiles to remain stable from the inception of the study to the 12-month assessment and from that time to the 24-month assessment. We describe the uses of these prototypical profiles and discuss the applicability of this analytical approach to other assessment instruments.

Adult↗

[Dimensional structure of the German version of the Brief Psychiatric Rating Scale (BPRS)].

Since the early 1960s the Brief Psychiatric Rating Scale (BPRS) has been one of the most frequently used standardized methods in international psychiatric research. The BPRS is used mainly for the rating of psychopathological symptoms of schizophrenic subjects. According to the results of factorial analyses, the original version of the BPRS is divided into five subscales, which have been preserved in the German translation. The validity of this original scale structure for the German BPRS version has not been investigated, however. A principal-components analysis of the 18 BPRS items carried out on the data of 301 schizophrenics yielded four factors that are comparable with four of the original subscales: Thought disturbance, Hostility/suspiciousness, Anxiety/depression, and Anergia. These results are compared with earlier findings and similarities and differences are discussed.

Adolescent↗

Assessing psychopathology in Chinese psychiatric patients in Hong Kong using the Brief Psychiatric Rating Scale.

This study investigated the use of the Brief Psychiatric Rating Scale (BPRS) in a sample of 155 Chinese psychiatric patients in Hong Kong. The commonly rated symptoms were those related to the spectrum of anxiety-depression, and the symptom dimensions differed only slightly from those symptom clusters reported in past studies with the BPRS. Although symptoms were rated regardless of psychiatric diagnoses, the BPRS profiles of these patients were sensitive to diagnostic distinctions. In addition, these patients were also classifiable into the 8 phenomenological types. However, the less elevated BPRS profiles across types raised the question of whether there was a tendency to under-present symptoms on the part of the patients or to under-rate symptoms on the part of the clinicians. These results were discussed in terms of the use of the BPRS for descriptive and classification studies in the Chinese setting as well as for cross-cultural research.

Adolescent↗

The brief psychiatric rating scale: effect of scaling system on clinical response assessment.

The Brief Psychiatric Rating Scale (BPRS) is an 18-item rating scale frequently used to assess change in psychopathology in schizophrenic patients in antipsychotic drug trials. BPRS items may be rated by the use of either a 1 to 7 or 0 to 6 scaling system, with the 1 or 0 rating indicating no pathology, respectively. When percent change in BPRS total score is used as an index of change, measurement considerations indicate that the 0 to 6 scaling system is preferable. Furthermore, when the 1 to 7 scaling system is used, patients whose initial BPRS values fall at the lower end of the range are classified as responders at a lower rate than are patients with higher initial scores. The adoption of the 0 to 6 scaling system for the BPRS and other rating scales, such as the Positive and Negative Syndrome Scale, is advocated.

Antipsychotic Agents↗

Factor structure of the expanded Brief Psychiatric Rating Scale.

This study investigated the factor structure of the expanded Brief Psychiatric Rating Scale (BPRS) on a sample of severe mentally ill homeless individuals. A confirmatory factor analysis using the Oblique Multiple Group method supported the typical five factor solution found in previous studies with the original BPRS. The five factors were labeled Thinking Disorder. Withdrawal. Anxiety-Depression, Hostility-Suspicion, and Activity. Alpha coefficients for four of the scales ranged from .73 to .81; however, the alpha coefficient for the Hostility-Suspicion scale was only .49.

Adult↗

Component structure of the expanded Brief Psychiatric Rating Scale (BPRS-E).

The component structure of the expanded Brief Psychiatric Rating Scale (BPRS-E) was analyzed in a sample (n = 150) of consecutively admitted general psychiatric inpatients and compared with a group (n = 97) of adolescent patients with schizophrenia spectrum diagnoses. A stable five-component solution, of which four were interpretable, was found across groups. The component scales of the 24-item version of the BPRS had good internal consistency, allowed better coverage of schizophrenia and affective symptoms than the 18-item version but did not distinguish the schizophrenia diagnostic subgroups. The implications of the findings are discussed.

Adolescent↗

Inpatient violence and the schizophrenic patient. A study of Brief Psychiatric Rating Scale scores and inpatient behavior.

A correlational analysis of Brief Psychiatric Rating Scale (BPRS) ratings and measures of inpatient violence in 207 schizophrenic patients is presented. Significant correlations were found between BPRS measures of schizophrenic symptomatology and several measures of inpatient violence including assault. BPRS subscales which related to paranoid symptoms were also significantly correlated with inpatient danger-related measures; however, to a lesser degree.

Adult↗

Evaluation of Mini Mental State Examination and Brief Psychiatric Rating Scale on aged schizophrenic patients.

Mini Mental State Examination (MMSE), Brief Psychiatric Rating Scale (BPRS) and subscales of the BPRS were performed on 73 elderly inpatients (mean age: 67.9 years; standard deviation: 7.2; range: 60-89) diagnosed with DSM-III-R chronic schizophrenia. Forty of the subjects were men and 33 were women. A significant negative correlation was observed between MMSE and the age, factor negative, factor depressive, and total score of BPRS. We believe, however, that it is relatively sufficient to screen for demented illness of schizophrenics using MMSE when considering the age and the psychiatric symptoms (especially negative or depressive symptoms ). Forty-eight (66%) of the 73 patients were categorized as 'demented' by MMSE. These results suggest that the aged inpatients with schizophrenia in a hospital showed certain kinds of cognitive deficits (including senile dementia) more frequently than the general population.

Aged↗

The factor structure of the Brief Psychiatric Rating Scale in Alzheimer's disease.

The factor structure of the Brief Psychiatric Rating Scale (BPRS) is well established with young psychiatric patients. A study by Overall and Beller showed, however, that its factor structure was different with geropsychiatric patients. Although the BPRS has been used in assessing the behavioral characteristics of patients with probable Alzheimer's disease (AD), its factor structure has not been established with these patients. The present study investigated the factor structure of the BPRS among patients with clinically diagnosed AD by (NINCDS/ADRDA) criteria. The scale had limited usefulness with outpatients with mild AD. The factor structure obtained was similar to that found with other patient groups, but a unique factor, including the items Tension and Uncooperativeness, probably reflects the behavioral and psychological agitation characteristic of some AD patients. We recommend caution be taken in generalizing data from younger psychiatric samples to older adult patients with dementia.

Adult↗

Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale.

Previous four- and five-factor solutions of the 18-item Brief Psychiatric Rating Scale (BPRS) suggested the possibility of an affective dimension in psychosis. A principal components analysis was used to analyze psychiatric symptom data rated on an expanded 24-item version of the BPRS. BPRS data were collected during a period of acute psychotic and affective illness with 114 young adult, recent-onset schizophrenia and schizoaffective patients and 27 bipolar manic patients. Principal components analyses of the 18-item and 24-item BPRS indicated a four-factor solution was the most interpretable. Principal components analysis of the 24-item BPRS produced a clear mania factor characterized by high loadings from items added to the 18-item BPRS, which included elevated mood, motor hyperactivity, and distractibility. This factor solution suggests that the 24-item BPRS allows for an expanded assessment of affective symptoms relating to a manic dimension. Potentially important symptoms that were added to the traditional 18-item version, namely suicidality, bizarre behavior, and self-neglect, also make clear contributions to other factors.

Adult↗

A cross-cultural study of the reliability and factorial dimensions of the Brief Psychiatric Rating Scale (BPRS).

The factor-structure and the reliability of the Brief Psychiatric Rating Scale (BPRS) was investigated in a group of short stay psychiatric patients in a Dutch university clinic. It was found that the BPRS has a good inter-rater reliability. With the exception of a new Disorientation subscale all original five subscales could be replicated when compared with an American study.

Adult↗

[Validity of the Brief Psychiatric Rating Scale].

The internal structure and validity of terms used in the Brief Psychiatric Rating Scale (Overall and Gorham, 1962) was analyzed. The data which had been gained at the entrance examination of 1557 inpatients with the diagnosis according to ICD-9 (schizophrenia simplex, schizophrenia paranoids, schizoaffective disease depressive type, schizoaffective disease manic type, manic-depressive disease manic phase, manic-depressive disease depressive phase) were processed using stepwise discriminant analysis (SDA). Three-dimensional space defined by SDA provided a sufficient frame of relations for the majority of diagnostic groups. Incomplete component analysis justified the assumption of a relatively stabile internal structure of the method. The findings allow to recommend the Czech version of the scale for the purpose of description of psychic impairments in psychiatry.

Adolescent↗

Brief psychiatric rating scale for children: quantitative scoring of medical records.

The utility of the Brief Psychiatric Rating Scale for Children (BPRS-C) for transcribing narrative medical records into standard quantitative form for research purposes is examined. Three clinicians independently read and rated the records of 40 child and adolescent patients. Interrater reliabilities were adequate in most major domains of psychopathology, the one notable exception being symptoms in the anxiety domain. On the basis of these results, the BPRS-C appears appropriate for use in administrative and audit reviews, as well as in epidemiological and program evaluation research in which medical records are the primary sources of information.

Adolescent↗