Rating scales
Score the Young Mania Rating Scale: eleven items, four of them double-weighted, for a 0–60 total — with the double-weighted subtotal shown separately, because that is where the scale is most often miscounted.
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Rate the person’s presentation on each item. Seven items run 0–4; the four×2double-weighted items run 0–8. The total ranges 0–60.
Total score
0 / 60
Sum of all eleven items
Severity band
Minimal / not manic
Samara et al., 2022 (CGI-S)
Double-weighted subtotal
0 / 32
four 0–8 items, 32 of the 60 points
Single-weighted subtotal
0 / 28
seven 0–4 items
Enter the pre-treatment total to see change from baseline and the 50% response criterion.
Remission (≤12)
Yes
Where the person is now
Plain text: every item with its range and code, the total, the band, both subtotals and the remission status.
The item set and the double weighting follow Young, Biggs, Ziegler & Meyer (1978); the severity labels use the approximate CGI-S equivalents from Samara, Levine & Leucht (2022). This is a scoring aid for education and research support, not a diagnosis: the total measures severity, cut-points vary more between mania protocols than for the depression scales, and the threshold you applied belongs in the report alongside the number. Rate the items above, or load the example, to see the score update.
Reference · for the curious
The Young Mania Rating Scale, published by Young, Biggs, Ziegler and Meyer in 1978, is the standard instrument for rating manic severity and the primary endpoint in most acute mania trials. It has one structural feature that generates more scoring errors than any other rating scale in common use: four of its eleven items are double-weighted.
Seven items — elevated mood, increased motor activity and energy, sexual interest, sleep, language and thought disorder, appearance, and insight — are rated 0–4. Four items are rated 0–8: irritability, speech rate and amount, thought content, and disruptive or aggressive behaviour. The total therefore runs 0 to 60, not 0 to 44.
Young and colleagues double-weighted those four deliberately. They are the items hardest to elicit reliably from a patient in an acute manic episode — someone who is irritable, pressured, and uncooperative with the interview is precisely the person whose irritability and pressured speech most need to count. Doubling their range keeps them influential in the total rather than swamped by items that are easier to rate.
The scorer above reports the double-weighted subtotal out of 32 separately, because that is where miscounting shows up. If your total looks low for a clearly manic presentation, check those four items first.
Scores of 12 or below are generally treated as remission, and a threshold around 20 is commonly used as an entry criterion for acute mania trials. Response is conventionally a 50% reduction from baseline, which is why this tool accepts a baseline score.
Beyond those conventions, banding varies between protocols considerably more than it does for the HAM-D or MADRS — there is no equivalent of the Snaith bands in universal use. State the cut-points you applied whenever you report YMRS results; without them the numbers are not comparable across studies.
Two features of the disorder work against the instrument. Insight is frequently impaired, so self-report is unreliable in exactly the states the scale is designed to measure — which is why there is no self-report YMRS in standard use. And the presentation is unstable: a patient can look markedly different across a day, so the rating window and the timing of the interview matter more than they would for depression.
Ratings normally draw on the interview plus collateral information from nursing staff or family, particularly for sleep and for disruptive behaviour. Record what your rating was based on. Two raters with access to different information are not disagreeing about the patient; they are rating different data.
Three of the eleven items — speech rate and amount, language and thought disorder, and thought content — are judgements about language. That makes the YMRS unusually well suited to transcript-based rating, and it is why the underlying phenomena overlap with formal thought disorder assessment. Our guides to the Thought, Language and Communication scale and positive formal thought disorder cover the speech phenomena in far more detail than the YMRS anchors do, and are worth reading if derailment or pressured speech is central to your work.
Where two raters score the same transcripts, measure agreement — and because the items are ordered, use weighted kappa or an ICC rather than unweighted kappa. The inter-rater reliability calculator computes both, and our guide to rating mania from speech covers the item anchors.
A parent-report version, the P-YMRS, exists for use with children and adolescents. It is a different instrument with different psychometrics, and its scores should not be compared directly with clinician-rated YMRS totals.
Young and colleagues reported inter-rater reliability of 0.93 for the total score, and internal consistency in the range of Cronbach's alpha 0.80 to 0.91 has been reported since.
Those are good figures with a caveat specific to mania. The ratings depend on eliciting behaviour from patients whose insight and cooperation are frequently impaired, so reliability in practice turns on rater training and on whether collateral information from staff or family was available and used. Two raters with access to different information will diverge without either of them misapplying the scale — which is an argument for recording what each rating was based on, not just what it was.
The YMRS is freely reproducible with citation and is hosted in the Tagaroo Scale Library. If you are working across mood states, the MADRS and HAM-D calculators cover the depressive pole.
This is a scoring aid for education and research support, not a clinical decision tool. Because YMRS ratings normally draw on collateral information as well as the interview — particularly for sleep and disruptive behaviour — a total entered here reflects only what you put in. All calculation happens in your browser; nothing is transmitted or stored.
Young and colleagues (1978) reported inter-rater reliability of 0.93 for the total score, and internal consistency in the range of Cronbach's alpha 0.80 to 0.91 has been reported subsequently. Those figures are good, but they come with a caveat specific to mania: ratings depend on eliciting behaviour from patients whose insight and cooperation are often impaired, so reliability in practice depends heavily on rater training and on whether collateral information from staff or family was available and used.
Seven items — elevated mood, increased motor activity, sexual interest, sleep, language and thought disorder, appearance and insight — are rated 0–4. Four items are double-weighted and rated 0–8: irritability, speech rate and amount, thought content, and disruptive or aggressive behaviour. Young and colleagues double-weighted these four because they are the hardest to elicit reliably from uncooperative patients, so the total is 0–60 rather than 44.
Scores of 12 or below are usually treated as remission, and a threshold around 20 is commonly used as an entry criterion for acute mania trials. Response is conventionally a 50% reduction from baseline. Bands vary between protocols more than for the depression scales, so state the cut-points you applied.
Because they were expected to be under-reported. The four double-weighted items depend on behaviour that a patient in an acute manic episode may not cooperate with rating — irritability, pressured speech, thought content and disruptive behaviour — so the authors gave them twice the range to keep them influential in the total. It is the single most common source of YMRS scoring errors, which is why this calculator reports the double-weighted subtotal separately.
The Young Mania Rating Scale, published by Young, Biggs, Ziegler and Meyer in 1978, is freely reproducible with citation. A parent-report version (P-YMRS) exists for paediatric use.
Written by Enrique Gutiérrez, PhD (Computer Science) — founder of Tagaroo and Associate Professor of Computer Science, working on inter-rater reliability, measurement and annotation methodology (ORCID).
How this page is checked. Scoring rules, item ranges and thresholds are transcribed from the instrument's cited primary sources and covered by automated tests that reproduce each paper's own worked examples. This page has not been reviewed by a licensed clinician, and it is a scoring aid for education and research support rather than a clinical decision tool.
Last verified: 29 July 2026. Formulas, thresholds and cited figures on this page were checked against their original sources on that date. Every calculation runs in your browser; nothing you enter is transmitted or stored.
Tagaroo lets you score the YMRS against the interview transcript, linking each item rating to the speech that justifies it — which is where pressured speech, thought disorder and irritability are visible in the first place.