Description: | The CARS-M is a 15-item, clinician-rated scale used to assess symptoms of mania and psychosis experienced by a patient over the last 7 days. | ||||||||||
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Disease States: | Bipolar disorder | ||||||||||
Validated Uses: | Treatment Monitoring & Evaluation, Symptom Severity | ||||||||||
Administration Method: | Clinician-report | ||||||||||
Time to administer: | 16-30 minutes | ||||||||||
Commonly used in: | Clinical Trials & Research | ||||||||||
Detailed Description: | The CARS-M is a 15-item, clinician-rated scale used to assess symptoms of mania and psychosis experienced by a patient in the last 7 days.1 The scale assesses mania and psychosis independently,1 with items 1–10 comprising the mania subscale and items 11–15 comprising the psychosis subscale.1 All items are scored on a 0–5 scale according to severity, with the exception of item 15, which assesses insight on a 0–4 scale.1 Behavioral anchors (ie, descriptive examples of symptoms or behaviors that would qualify a patient for a given rating score) and sample questions are provided for each item to facilitate clinician ratings.2,4 Items are then summed to generate a mania subscore (range: 0–50) and a psychosis subscore (range: 0–24).2 Severity thresholds used to classify patients are shown in the table below.1,2
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Scale Validity: | Psychometric properties of the CARS-M were assessed in a study with 14 adult inpatients with schizophrenia, major depressive disorder, or bipolar disorder.1 Inter-rater reliability across 5 trained raters was good, ranging from 0.66 to 0.94 for the 15 individual items (average = 0.83).1 A second study of 44 adult inpatients with bipolar disorder also demonstrated that sensitivity and specificity of the CARS-M is high.5 Using a cutoff value of 15 to distinguish patients with mild symptoms or no symptoms from patients with moderate symptoms, the CARS-M mania subscale had a sensitivity of 0.97 and specificity of 0.95.5 | ||||||||||
Alternative Versions: | No alternative versions have been identified in the literature. | ||||||||||
Cited Limitations: | No studies have examined if the CARS-M can distinguish between mania due to schizophrenia and mania due to bipolar disorder.1 Similarly, the CARS-M cannot be used to assess mixed states unless it is paired with another scale assessing depressive symptoms, such as the Hamilton Depression Rating Scale.1,2,6 |
Footnotes:
Supporting references for the filters are as follows:
Disease States: Bipolar disorder1 ; Validated Uses: Treatment Monitoring & Evaluation1, Symptom Severity1,2; Populations: Adult1,2; Administration Method: Clinician-report1,2; Time to Administer: 16–30 minutes1,2; Commonly used in: Clinical Trials & Research3