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PubMed2000

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↗
PubMed1983

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↗
PubMed1994

[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↗
PubMed2005

[Factor analysis and validation of a Spanish version of the Brief Psychiatric Rating Scale in Colombia].

INTRODUCTION: A validation study was directed toward an evaluation of the Brief Psychiatric Rating Scale (BPRS) in a Spanish-language version in Colombia. The BPRS is important because it is one of the most widely used scales in clinical and research settings in mental health. METHODS: The BPRS was administered to 149 psychiatric impatients and the scores evaluated for factorial structure and internal consistency. Test-retest and inter-rater reliability were assessed in a sub-sample of 30 patients. Concurrent validity was analyzed by comparing scores on BPRS with scores on GAF scale. Sensitivity to change was evaluated by comparing scores in two clinically different settings. RESULTS: Principal component factor analysis indicated a structure with three domains: schizophreniform, bipolarity and depression. The instrument showed good internal consistency (Cronbach's alpha = 0.79). Coefficients corresponding to inter-rater and test-retest reliability were 0.94 and 0.82 respectively. Correlation between BPRS and GAF was 0.7 (Spearman). Within-subjects ANOVA showed the scale to be an instrument good sensitivity for detecting changes in of clinical characteristics. CONCLUSION: We concluded that the Spanish language version evaluated in Colombia to be a valid clinical-report instrument with adequate psychometric properties.

Adult↗
PubMed1986

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↗
PubMed1991

Psychometric evaluation of a standardized and expanded Brief Psychiatric Rating Scale.

The interrater reliability, factorial and discriminant validity of a standardized and expanded Brief Psychiatric Rating Scale (BPRS-E) were investigated in a heterogeneous short-stay group of psychiatric inpatients in the Netherlands (n = 162). Repeated separate interviews by single clinicians (psychiatrists, residents or clinical psychologists), best reflecting the way the BPRS is usually employed in clinical practice and psychopharmacological research, were used to determine interrater reliability (n = 79). Although the 5 subscales of the original 18-item BPRS (BPRS-18) were successfully cross-validated in this Dutch sample, 4 of these subscales (except for thought disturbance) were found to lack interrater reliability. The 10-item schizophrenia scale derived from the BPRS-18 by a Scandinavian group met the standard of acceptable interrater reliability; BPRS-18 and BPRS-E global scales approximated this standard. For the thought disturbance subscale, the schizophrenia scale and for BPRS-18 and BPRS-E global scales, findings supported discriminatory power.

Acute Disease↗
PubMed1986

Comparison between the Brief Psychiatric Rating Scale and the Manchester Scale for the rating of schizophrenic symptoms.

A reliability study was carried out to compare the short Manchester Scale (MS) to the longer Brief Psychiatric Rating Scale (BPRS), to see if similar items scored the same aspect of pathology and to find the sources of error. The raters were a psychiatrist and a psychologist cum medical student; they had recently arrived in Britain, came from different cultures and had not used the scale previously. Comparisons between the scales were made by interviewing the patients separately and together using either one or both scales. The items on the MS showed a higher interrater reliability as compared to the BPRS, both with independent and simultaneous ratings. Items based on observation only correlated poorly as compared to items based on verbal report. Lower between-scale correlations for delusions and affect were observed even where the same rater used the two scales, suggesting that the scales have different meanings for these items. The MS is a suitable alternative to the BPRS for quantifying schizophrenic symptoms.

Affect↗
PubMed2005

Meta-analysis of the brief psychiatric rating scale factor structure.

A meta-analysis (N=17,620; k=26) of factor analyses of the Brief Psychiatric Rating Scale (BPRS) was conducted. Analysis of the 12 items from Overall et al.'s (J. E. Overall, L. E. Hollister, & P. Pichot, 1974) 4 subscales found support for his 4 subscales. Analysis of all 18 BPRS items found 4 components similar to those of Overall et al. In a 5-component solution, a 5th activation component emerged but was best supported among samples of schizophrenic patients. The first 4 components appear to form the core of the BPRS factor structure. Results of the meta-analysis suggest 5 subscales (with items in parentheses): Affect (anxiety, guilt, depression, somatic); Positive Symptoms (thought content, conceptual disorganization, hallucinatory behavior, grandiosity); Negative Symptoms (blunted affect, emotional withdrawal, motor retardation); Resistance (hostility, uncooperativeness, suspiciousness); and Activation (excitement, tension, mannerisms-posturing).

Brief Psychiatric Rating Scale↗
PubMed2004

Predicting inpatient length of stay with the expanded version of the Brief Psychiatric Rating Scale (version 4.0).

This study examined whether assessment data from administration of the extended version of the Brief Psychiatric Rating Scale (BPRS-E) to state hospital patients within 72 hours of their admission could be used to predict length of hospital stay. BPRS-E data for 222 first-admission patients, for whom the mean length of stay was 118.4+/-88.6 days, were factor analyzed, yielding a model with four factors: patient's resistance to treatment, positive symptoms, mood, and negative symptoms. Discriminant analysis showed that the negative symptoms factor (blunted affect, emotional withdrawal, motor retardation, self-neglect, and disorientation) correctly predicted whether length of stay would exceed the mean in 94 percent of cases. The findings suggest that the severity of negative symptoms can be a useful predictor of length of stay among patients with severe and persistent mental illness.

Adult↗
PubMed2005

Generalizability of brief psychiatric rating scale prototypical profiles and their use in evaluating treatment outcomes.

The generalizability of previously isolated prototypical profiles of the Brief Psychiatric Rating Scale (BPRS) was examined in a sample of homeless individuals with both severe mental illness and substance-use problems who were part of a 24-month study that evaluated the effectiveness of various treatment interventions. These prototypical profiles (depressed, actively psychotic, and withdrawn) did generalize to the new sample, with a 59.4% coverage rate. In addition, some of the participants' BPRS profiles (10%) were characterized by negative correlations with the withdrawn profile (termed agitated) and others (17%) by minimal within-profile variability (labelled flat). Overall, with these additions, the coverage of the prototypical profiles was 86.4%. These prototypical profiles were then used to evaluate changes in profile elevation and shape over the course of the study. Generally, changes in both profile elevation and shape were moderated by the particular prototypical profile that the participants resembled. The use of these prototypical profiles in evaluating change permits a more precise analysis of what kind of individuals manifest particular effects. The clinical meaning of the BPRS profile changes observed was also discussed.

Adult↗
PubMed2003

A confirmatory factor analysis of the Brief Psychiatric Rating Scale in a homeless sample.

This study used a confirmatory factor analysis procedure, the Oblique Multiple Group Method (OMG), with the Brief Psychiatric Rating Scale (BPRS) on a sample of homeless individuals who had both a severe mental illness and a substance use disorder. The hypothesized five-factor model of Guy (1976) accounted for 93% of the possible variance, and all the appropriate scales had their highest loading on their respective hypothesized factor. In addition, the Guy model accounted for more variance than did an alternative model. The five factors were labelled: thinking disorder, anergia, anxiety-depression, hostility-suspicion, and activity.

Adult↗
PubMed2005

Brief psychiatric rating scale expanded version: How do new items affect factor structure?

Our goal was to suggest a factor structure for the Brief Psychiatric Rating Scale Expanded Version (BPRS-E) based upon a large and diverse sample and to determine which of the new items improved the factors derived from the 18-item version of the scale that have been used in clinical research for decades. We investigated the consistency of our proposed model over time and across demographic groups. As part of the Texas Medication Algorithm Project, the BPRS-E was administered to a total of 1440 psychiatric outpatients in three different diagnostic groups on multiple occasions. The sample was randomly split so that exploratory factor analysis could be done with the first half, and the model could be confirmed on the second half. A four-factor structure including factors assessing depression/anxiety, psychosis, negative symptoms, and activation was found. For each factor, we specify items in the expanded version that added to the breadth of the commonly used clinical factors while improving or maintaining goodness of fit and reliability. The final model proposed was consistent over time and across diagnosis, phase of illness, age, gender, ethnicity, and level of education. The BPRS-E has a stable four-factor structure, making it useful as a clinical outcome measure.

Adult↗
PubMed1984

The Brief Psychiatric Rating Scale (BPRS) in geropsychiatric research: II. Representative profile patterns.

Cluster analysis methods were used to classify Brief Psychiatric Rating Scale profiles for a sample of 88 geropsychiatric patients. Five distinct profile patterns were found to represent adequately most differences in symptom and behavior characteristics of the aged patients. The five phenomenological types are described as agitated dementia, retarded dementia, anxious depression, withdrawn depression, and paranoid psychosis. The appropriateness of this nomenclature is examined with reference to clinical diagnosis, mental status examination, and drug treatment. Prototype profile patterns that can be used to classify future geropsychiatric patients are presented, and a sequence of clinical decisions that should result in similar partitioning of the patient population is discussed.

Aged↗
PubMed1989

The Brief Psychiatric Rating Scale. Dimension of schizophrenia--reliability and construct validity.

This study has focussed on a 10-item Brief Psychiatric Rating Scale (BPRS) subscale for the quantification of schizophrenic states. Seven psychiatrists interviewed jointly patients who all fulfilled the DSM-III criteria of schizophrenia, and in a subsequent pencil-and-paper procedure a judgment analysis was performed. The reliability analysis showed that less experienced BPRS raters made less consistent judgments implying the cautionary statement that the proper use of a scale for schizophrenia requires specialized training with the scale. The validity analysis showed that the BPRS items had an additive relationship implying that the sum of these items is a sufficient statistic for the measurement of severity of schizophrenic states. Finally, the results seem to indicate, that the underlying dimension defined by the 10-items BPRS subscale includes hierarchically the negative and positive symptoms of schizophrenia.

Adult↗
PubMed1997

Use of the Brief Psychiatric Rating Scale to measure success in a psychosocial day program.

This study contrasted six subscales of the Brief Psychiatric Rating Scale (BPRS) to determine their sensitivity to psychosocial treatment outcome. An expanded version of the BPRS was administered to 216 clients on admission to a day program. The subscale measuring hostility and suspiciousness discriminated at intake clients who were therapeutically discharged from clients who did not complete the program and predicted discharge status after the investigators controlled for the effects of demographic variables. Significant reductions in scores were obtained on five subscales for a subset of clients to whom the BPRS was readministered before discharge. The results support the use of the expanded BPRS as an evaluative tool in psychosocial rehabilitation programs.

Adult↗
PubMed2002

Factor structure of Bech's version of the Brief Psychiatric Rating Scale in Brazilian patients.

The objective of the present study was to evaluate the factor structure of Bech's version of the Brief Psychiatric Rating Scale (BPRS), translated into Portuguese. The BPRS was administered to a heterogeneous group of psychiatric inpatients (N = 98) and outpatients (N = 62) in a University Hospital. Each patient was evaluated from one to eight times. The interval between consecutive interviews was one week for the inpatients and one month for the outpatients. The results were submitted to factorial analysis. The internal consistency of the total scale and of each factor was also estimated. Factorial analysis followed by normalized orthogonal rotation (Varimax) yielded four factors: Withdrawal-Retardation, Thinking Disorder, Anxious-Depression and Activation. Internal consistency measured by Cronbach's alpha coefficient ranged from 0.766 to 0.879. The data show that the factor structure of the present instrument is similar to that of the American version of the BPRS which contains 18 items, except for the absence of the fifth factor of the latter scale, Hostile-Suspiciousness.

Brazil↗
PubMed2000

Course of illness following specialized inpatient treatment for women with trauma-related psychopathology.

The authors report findings from repeated assessments of 101 women who received intensive inpatient treatment focused on trauma-related disorders. All patients were assessed at admission and discharge, and half were reassessed at 1-year follow-up. Measures included the Global Assessment Scale, Brief Psychiatric Rating Scale, Brief Symptom Inventory, Role Functioning Scales, Follow-up Adjustment Scale, and Client Satisfaction Questionnaire. As a group, patients improved substantially during hospitalization and maintained gains at follow-up, although they showed a trend toward relapse in some symptom areas. However, a substantial minority of patients continued to show severe impairment at follow-up. In light of continual need for changes in clinical programs in the face of declining reimbursement, there is a pressing need for future outcome research on specialized trauma programs to relate subsequent clinical course to specific treatment interventions.

Adult↗
PubMed2001

New subscales for an anchored version of the Brief Psychiatric Rating Scale: construction, reliability, and validity in acute psychiatric admissions.

Attending psychiatrists completed an anchored version of the 18-item Brief Psychiatric Rating Scale (BPRS-A) based on admission and evaluation information on a total of 2,921 adult patients treated at 1 public sector acute psychiatric teaching hospital. Exploratory factor analysis was applied to a 6-month sample to construct 4 nonoverlapping subscales: Resistance, Positive Symptoms, Negative Symptoms, and Psychological Discomfort. Confirmatory factor analysis compared these new subscales to 3 other published subscale models using a second 6-month sample. Internal consistency, rater influence, and interrater agreement were estimated in separate studies. Discriminant validity was explored by comparison of diagnosis-based samples. Application of the BPRS-A as a debriefing instrument in the study of symptomatic change and the multiple challenges inherent in psychometric study of such a rating scale in realistic hospital practice are discussed.

Adult↗