|Description:||The Rapid Mood Screener (RMS) is a novel, pragmatic, patient-reported tool to assess patients for bipolar I disorder.1 The RMS is a screening tool that was developed to help differentiate bipolar I disorder from major depressive disorder (MDD) in patients with depressive symptoms who have been diagnosed with MDD.1|
|Disease States:||Bipolar disorder|
|Time to administer:||Less than 5 minutes|
|Commonly used in:||Clinical Practice|
|Detailed Description:||The RMS was developed to help reduce the misdiagnosis of patients with bipolar I disorder. Approximately 70% of patients with bipolar I disorder are initially misdiagnosed, with MDD being the most common misdiagnosis.1 Consequently, patients with bipolar I disorder often experience a delay of 6 to 10 years between symptom onset and diagnosis. The RMS was developed to help address this gap in clinical care by helping clinicians arrive at a more timely and accurate diagnosis of bipolar I disorder, especially among patients exhibiting depressive symptoms who may be at risk for a misdiagnosis of MDD.1
The RMS was developed in a 3-step process. First, a review of the literature on bipolar disorder was conducted. Next, an initial set of test items was drafted by a multidisciplinary team (eg, primary care clinicians, psychiatric nurse practitioners, psychiatrists, etc.), who then evaluated the draft items among a group of adults with bipolar I disorder and modified them based on their findings. Finally, the next iteration of the draft underwent validation testing in a sample of patients with a confirmed diagnosis of bipolar I disorder or MDD.1 The test items were specifically written in a way that is easy for patients to understand, hence why it is considered a pragmatic screening tool.1
The RMS includes 6 items (“yes” or “no” questions)—3 items that screen for depressive characteristics that are more likely to indicate bipolar I disorder than MDD, and 3 items that screen for mania.1 It is scored by counting the total number of “Yes” responses. A “Yes” response on 4 or more items is considered a positive screen and thus suggests a very high likelihood of bipolar I disorder. A positive screen should be followed by a full diagnostic evaluation.1
|Scale Validity:||A validation study has reported the sensitivity, specificity, and accuracy of the RMS. “Sensitivity” refers to the percentage of patients with bipolar I disorder who are correctly identified as positive, whereas “specificity” is the percentage of patients who do not have bipolar I disorder who are correctly identified as negative.1 “Accuracy” refers to the percentage of patients correctly predicted as having bipolar I disorder or correctly predicted as not having the disorder.1
A “Yes” response on 4 or more items is suggestive of probable bipolar I disorder, with a sensitivity of 88%, a specificity of 80%, and an accuracy rate of 84%. By comparison, one validation study found that when the Mood Disorder Questionnaire (MDQ) was administered in a sample that also was administered the RMS, positive screens on the MDQ had a sensitivity of 86% and a specificity of 78%.1
Finally, a “Yes” response on 3 or more items is more suggestive of bipolar I disorder than MDD, with a sensitivity of 97%, a specificity of 59%, and an accuracy rate of 77%.1
|Cited Limitations:||The RMS is designed to assess patients with bipolar I disorder and has not been validated in patients with hypomania or bipolar II disorder. It also may not be generalizable to nonmedicated patients.1
The RMS needs to be further validated in real-world settings.1 One survey done in 200 healthcare providers found that 81% of healthcare providers reported they were more likely to use the RMS instead of the MDQ. Additionally, 84% of healthcare providers reported feeling that the RMS would impact their practice in a positive way, and 76% reported they intend to use the RMS to screen patients with depressive symptoms for bipolar I disorder.1,2
Finally, individual items on the RMS may need to undergo further evaluation for certain test characteristics (eg, sensitivity and specificity of individual test questions, and needed modifications to individual test questions).1
Footnotes:Supporting references for the filters are as follows: Disease States: Bipolar I disorder;1,2 Validated Uses: Screening;2 Population: Adults;2 Administration Method: Self-report;1,2 Time to Administer: Less than 5 minutes;1,2 Commonly Used In: Clinical practice2
The RMS is not a diagnostic tool. The content presented here is provided for educational purposes only. It is not intended as, nor is it a substitute for medical care or advice. Healthcare professionals should use their clinical judgment when reviewing educational resources on NP Psych Navigator.
The Rapid Mood Screener tool was developed with funding and input provided by AbbVie and external experts, who received financial support from AbbVie for research, honoraria and/or consulting services depending on the author.
- McIntyre RS, Patel MD, Masand PS, et al. The Rapid Mood Screener (RMS): A novel and pragmatic screener for bipolar I disorder. Curr Med Res Opin. 2021;37(1):135-144.
- Thase ME, et al. Healthcare provider perspectives on bipolar I disorder screening and the Rapid Mood Screener (RMS), a pragmatic, new tool. CNS Spect. 2021;26(2):181-3.