The YMRS is a mania scale a clinician scores from an interview and what they see during it, usually covering the past 48 hours. Its 11 items total 0 to 60 and show how severe mania is and how it changes with treatment. Read what each band means and how to judge response and remission, then record the result with the free template. The official scale and its anchors are in the 1978 paper.
YMRS result template
FreeYOUNG MANIA RATING SCALE Date and time: [Date and time of the rating] Patient: [Name or record number, age] Setting: [Inpatient unit, emergency department, outpatient clinic, or study visit] RATER AND SOURCES Rater: [Name, role, and whether they also rated the baseline] Period covered: [Past 48 hours, or past 7 days if your protocol uses a week] Sources: [Interview, what was observed during it, nursing notes, family or carer report] Cooperation: [Full, partial, or limited, and how that shaped the rating] RESULT YMRS total: [0 to 60] Band: [Minimal or remission 0 to 12, mild 13 to 19, moderate 20 to 25, severe 26 to 60; name another set if your service uses one] Double-weighted items: [Irritability, speech, thought content, disruptive or aggressive behavior, each scored 0 to 8] Other items scored high: [Elevated mood, energy, sleep, sexual interest, language, appearance, or insight] COURSE Baseline YMRS: [Date, total, and the treatment started then] Change: [Points and percent since baseline] Status: [Response if down by half or more, remission if 12 or under, partly better, no change, or higher] SAFETY Aggression and agitation: [Incidents, emergency medicine or seclusion used, or none] Suicide and low mood: [Asked directly, mixed features, depression scale score if one was used] Risky behavior: [Spending, driving, sexual risk, alcohol or drugs, or none] PLAN Treatment: [Continue, change a dose, add or switch a medicine, check drug levels] Level of care: [Stay on the unit, pass home, discharge, day program, or clinic follow-up] Next YMRS: [Date, with the same rater and period where possible] Signed: [Name, credentials]
Use it for
Decide the period you’ll rate and gather what others have seen. People with mania often play down their symptoms or don’t see them.
Avoid: Rating someone straight after emergency sedation. The calm it brings isn’t a fall in mania; note it and rate again when it has worn off.
A clinician interviews the patient for about 15 to 30 minutes and rates each area from what the patient says and what they see.
Avoid: Scoring from the chart alone. The scale depends on seeing the patient.
Four items score 0 to 8 and seven score 0 to 4. Add the 11 for a total from 0 to 60.
Avoid: Scoring the four double-weighted items on the 0 to 4 range. It shrinks the total and breaks comparison with past ratings.
The band shows how severe mania is now; the change from baseline shows whether treatment is working.
Avoid: Calling a falling total recovery when insight is still poor. Poor insight is linked with stopping medicine after discharge.
The YMRS rates manic symptoms only. Safety and depression need their own questions at every rating.
Avoid: Reading a low total as stable mood. A patient can score 6 on the YMRS and be deeply depressed.
Each one follows the recording template. Use them to judge how much to write.
Inpatient psychiatry unit, day 10 of admission, rated on the ward
Rated by the ward psychiatrist who did the admission rating, covering the past 48 hours. Interview of 20 minutes, with nursing notes on sleep and behavior and a phone call with her sister. Fully cooperative today; on day 1 she walked out of the interview twice.
YMRS 14: mild. Double-weighted items: irritability 2, speech 4, thought content 2, disruptive or aggressive behavior 0. Elevated mood 2, insight 2, motor activity 1, sleep 1; sexual interest, language, and appearance 0.
29-year-old woman with bipolar I disorder, second manic episode. Admission YMRS 32, severe, on October 20: no sleep for three nights, nonstop talking, and plans to put her savings into three new businesses. Lithium and olanzapine started that day. Down 18 points, 56%: a response, not yet remission.
One episode of shouting at staff on day 2, settled with an extra dose of olanzapine; none since. Asked directly about suicidal thoughts: none, and no low mood so far. Her bank cards are with her sister after about $4,000 of spending in the week before admission.
Lithium level 0.8 on day 7, in range. Continue lithium 900 mg a day and olanzapine 15 mg at night. Day pass home with her sister this weekend. Next YMRS on day 13 by the same psychiatrist; discharge when it’s 12 or under and the pass has gone well, with a clinic visit within 7 days and a watch for depression as the mania lifts.
Outpatient bipolar disorder clinic, six-month review in person
Rated by his nurse practitioner, who has done every rating since 2023, covering the past 7 days as the clinic’s protocol sets. Interview of 15 minutes; his wife joined for the last part. Fully cooperative.
YMRS 8: minimal, inside the remission range of 12 or under, though above the stricter 7 some services use. Double-weighted items: irritability 2, speech 2, thought content 0, disruptive or aggressive behavior 0. Sleep 2, motor activity 1, elevated mood 1; the other four 0.
44-year-old man with bipolar I disorder, last manic episode in 2022. YMRS 6, 9, and 7 at his last three reviews, so 8 sits in his usual range. The points today come from a week of work deadlines: about 6 hours’ sleep a night against his usual 7 and a half, and his wife says he’s been quicker to snap.
No aggression. No suicidal thoughts when asked, and PHQ-9 of 4. No extra spending, and alcohol unchanged at 2 to 3 drinks a week.
Mood stable; no change to lithium 900 mg a day. Level 0.7 last week, kidney and thyroid tests normal. Sleep plan for the deadline weeks. He and his wife went over his early warning signs: under 6 hours’ sleep two nights running, talking over people, and new big projects; if they appear, he calls the clinic that week. Next YMRS and PHQ-9 in 6 months.
A 48-hour rating and a one-week rating aren’t the same measurement. Record the period every time, and keep it the same across a course of treatment.
Mania often comes with poor insight. Use what you see in the interview, nursing notes, and family reports, or the total will understate the illness.
The scale scores no depressive symptoms. Ask about low mood and suicidal thoughts at every rating, and add a depression scale when they’re present.
Stimulants, steroids, thyroid disease, and lost sleep can all raise the total. The YMRS measures severity; the diagnosis comes from the full assessment.
A 22 is moderate in one common table and mild in another. Name the set in the record, and judge change by points and percent, which mean the same in any set.
Vero Scribe records the YMRS result in your template from the visit, with the patient’s consent, or from your dictation: the period rated, the total and band, the change from baseline, safety, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
A trained clinician interviews the patient and rates 11 items from what they say and what the clinician sees. Irritability, speech, thought content, and disruptive or aggressive behavior score 0 to 8; the other seven items score 0 to 4. Adding them gives a total from 0 to 60. Use the anchors on the official form.
In one common working set, 0 to 12 is minimal or remission, 13 to 19 mild, 20 to 25 moderate, and 26 to 60 severe. Acute mania trials usually enroll people at 20 or more. Another widely shared table calls 20 to 25 mild and starts severe at 38, so name the set you use in the record.
Response usually means a fall of half or more from the baseline total. Remission is most often a total of 12 or less, and stricter definitions use 7 or less. A fall from 32 to 14 is a response, but 14 is still above the remission line.
The original scale rates the past 48 hours, from the patient’s account and what the rater sees in the interview. Many trials and services rate the past week instead. Either works if you record which one you used and keep it the same each time.
No. It measures how severe manic symptoms are now, in someone already assessed. Questionnaires such as the Mood Disorder Questionnaire screen for a lifetime history of manic or hypomanic episodes, and the diagnosis comes from the clinical history.
They rate opposite poles. The YMRS measures manic symptoms, scored 0 to 60; the HAM-D measures depression, scored 0 to 52 on the 17-item version. Both are clinician-rated from an interview, and bipolar disorder trials and clinics often use them together, especially when mood has mixed features.
Clinicians use the YMRS itself with children and teenagers, often with a parent’s account. A separate parent version, the P-YMRS, has a parent rate the same 11 areas. It picks up most children with bipolar disorder but also flags many who don’t have it, so a high score leads to a full assessment.
A clinician trained in the scale and experienced with mania: usually a psychiatrist, psychiatric nurse or nurse practitioner, psychologist, or trained research rater. Practice ratings and checking agreement with colleagues matter more than profession.
The scale was published with Young’s 1978 paper in the British Journal of Psychiatry, and the Royal College of Psychiatrists holds the copyright. It’s widely used in clinics and trials; check with the publisher before reprinting it or building it into software. The recording template on this page is free to copy or download.
Nine questions on the last two weeks: depression screening and severity, scored 0 to 27.
Two questions on interest and mood: a quick first screen for depression, scored 0 to 6.
Seven questions on worry and tension: anxiety screening and severity, scored 0 to 21.
Up to six questions on suicidal thoughts and behavior; the highest yes sets low, moderate, or high risk.
Twenty items on the past month: PTSD screening and symptom tracking, scored 0 to 80.
The clinician-rated depression scale often used alongside the YMRS, scored 0 to 52.
Follow-up visits with symptoms, medicines, levels, risk, and the plan.
Common codes for bipolar disorder, depression, and anxiety.
Ward rounds and medication follow-ups documented from the visit.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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