Altman Self-Rating Mania Scale (ASRM)

The Altman Self-Rating Mania Scale (ASRM) is a brief, 5-item self-rated assessment tool used to evaluate the symptoms of mania present in a patient for the past week.
Description: The Altman Self-Rating Mania Scale (ASRM) is a brief, 5-item self-rated assessment tool used to evaluate the symptoms of mania present in a patient for the past week.
Disease States: Bipolar disorder
Validated Uses: Screening, Treatment Monitoring & Evaluation, Symptom Severity
Administration Method: Self-report
Time to administer: Less than 5 minutes
Commonly used in: Clinical Practice
Detailed Description: The ASRM is a 5-item, multiple-choice questionnaire in which manic symptoms are rated 0 to 4 according to severity.1,2 Items are designed to probe for the following domains: elevated mood, increased self-esteem, decreased need for sleep, pressured speech, and psychomotor agitation over the past week.1 The ASRM scale is scored by simple addition, with total scores greater than 5 indicating mania.1,2
Scale Validity: The ASRM has 93% sensitivity and 33% specificity according to a validation study performed in English-speaking adults younger than 65 years and living in the United States.2
Alternative Versions: Although the ASRM was originally published in 1997 as a 5-item scale, the scale has alternative versions with 11 items and 14 items.4 The 11-item version includes 1 question for each of the 11 primary symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4).4 The 14-item version adds to this by probing for these 11 symptoms as well as 3 psychotic symptoms (auditory hallucinations, visual hallucinations, and delusions).4 Please note that the 5-item ASRM is contained within the extended 11-item and 14-item versions and thus can be extracted from these scales.4,*
Cited Limitations: The ASRM may not be a comprehensive assessment and does not evaluate all the potential mania symptoms that a patient may experience.4 Because questions do not assess duration or functional impairment associated with symptoms, the scale cannot differentiate between mania and hypomania.7

Footnotes:

*Although the 5-item ASRM is described here, we include information about alternative versions for your general awareness and convenience. These alternative versions may be used by different practitioners or in clinical trial or research settings.
 

Supporting references for the filters are as follows:
Disease States: Bipolar disorder1,2; Validated Uses: Screening,3 Treatment Monitoring & Evaluation,1,3 Symptom Severity1,2; Administration Method: Self-report1,2; Time to administer: < 5 minutes1; Commonly used in: Clinical Practice4-6
 

This resource is intended for educational purposes only and is intended for US healthcare professionals. Healthcare professionals should use independent medical judgment. All decisions regarding patient care must be handled by a healthcare professional and be made based on the unique needs of each patient. 
 

ABBV-US-01583-MC, Version 1.0 
Approved 04/2024 
AbbVie Medical Affairs 

References:

  1. Altman EG, Hedeker D, Peterson JL, Davis JM. The Altman Self-Rating Mania Scale. Biol Psychiatry. 1997;42(10):948-955. doi:10.1016/S0006-3223(96)00548-3 
  2. Altman E, Hedeker D, Peterson JL, Davis JM. A comparative evaluation of three self-rating scales for acute mania. Biol Psychiatry. 2001;50(6):468-471. doi:10.1016/s0006-3223(01)01065-4 
  3. Beidas RS, Stewart RE, Walsh L, et al. Free, brief, and validated: standardized instruments for low-resource mental health settings. Cogn Behav Pract. 2015;22(1):5-19. doi:10.1016/j.cbpra.2014.02.002 
  4. Altman EG, Østergaard SD. The 11-item and 14-item versions of the Altman Self-Rating Mania Scale. Acta Psychiatr Scand. 2019;139(3):292-293. doi:10.1111/acps.12988 
  5. Cerimele JM, Goldberg SB, Miller CJ, Gabrielson SW, Fortney JC. Systematic review of symptom assessment measures for use in measurement-based care of bipolar disorders. Psychiatr Serv. 2019;70(5):396-408. doi:10.1176/appi.ps.201800383 
  6. STABLE National Coordination Council. Standards for Bipolar Excellence Resource Toolkit. STABLE National Coordination Council; 2015. 
  7. Miklowitz DJ, Price J, Holmes EA, et al. Facilitated integrated mood management for adults with bipolar disorder. Bipolar Disord. 2012;14(2):185-197. doi:10.1111/j.1399-5618.2012.00998.x 

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