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Development and Reliability Andrew Francis PhD MD Penn State Medical SchoolHershey Med Center PA No disclosures No industry or federal support Fulltime salaried Penn State employee ID: 915310
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Bush-Francis Catatonia Rating Scale [BRCRS]
Development and Reliability
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Andrew Francis PhD MD
Penn State Medical School/Hershey Med Center, PA
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Slide2No disclosuresNo industry or federal support
Full-time, salaried Penn State employee
Off-Label use of Rxs for catatoniawww.catatonia.org
Slide3Slide4Slide514 Screening items tended to be more represented in literature
6/14 “hyperactive” and 8/14 “hypoactive”
Slide63. Mutism:
Verbally unresponsive or minimally responsive.
0= Absent
1= Verbally unresponsive to majority of questions; incomprehensible whisper.
2= Speaks less than 20 words/5 minutes.
3= No speech.
Bush-Francis Catatonia Rating Scale
18/23 items: graded on 0-3
pt
score
5/23 items: absent=0, present=3
Slide7Slide8DSM-5 Catatonia Specifier
DSM-5 293.89 --- ICD-10 F06.1
Slide9Criterion of 2/14 signs to define a caseEqual weighting of all rating scale items
A Priori
decision-- to capture mild casesData: frequency distribution among psychiatric patients
Data: frequency vs. severity of catatonic signs
Data: “primary” and “secondary” signs for Dx
Slide10Slide11Slide12Slide13Slide14Kappa Scores: Screening 0.83, Severity 0.73
Prospective, before and during Tx, N=44 largest to date for psychiatric cases
Slide15N=3 cases, 6 observers
Sarkar S et al. Assessing catatonia using four different instruments: Inter-rater reliability and prevalence in inpatient clinical population, Asian J
Psychiatr 23: 27-31, 2016.
Slide16“Interrater reliabilities for the various catatonic scales (Rosebush, MRSs, MRSc
, BFCRS) revealed average intraclass correlation coefficients between 0.90 and 0.96.”
N=34 catatonia cases, mixed prospective/retrospectiveNorthoff G, et al. Catatonia as a Psychomotor Syndrome: A Rating Scale and Extrapyramidal Motor Symptoms. Mov Disor
14: 414-416, 1999
.
Slide17Conclusions
BFCRS remains the standard for clinical use and research
BFCRS has rational basis in designReflects prior work, dating from KahlbaumCovers range of catatonic subtypes Acceptable IRR based on data to date, with caveat: research context