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Altman Self-Rating Mania Scale (ASRM)

The 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 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
Populations: Adult
Administration Method: Self-report
Time to administer: < 5 minutes
Commonly used in: Clinical Practice
Detailed Description: The ASRM is a 5-item, multiple-choice questionnaire in which manic symptoms are rated on a 0–4 scale according to severity.1,2 Items are designed to probe the following domains: elevated mood, increased self-esteem, decreased need for sleep, pressured speech, and psychomotor agitation 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 one question for each of the 11 primary symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV).4 The 14-item version adds to this by probing these 11 symptoms as well as three 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: Screening3, Treatment Monitoring & Evaluation1,3, Symptom Severity1,2; Populations: Adult1-3; Administration Method: Self-report1,2; Time to administer: < 5 minutes1; Commonly used in: Clinical Practice4-6

References:

  1. Altman, EG et al. Biol Psychiatry. 1997;42(10):948-955.
  2. Altman, E et al. Biol Psychiatry. 2001;50(6):468-471.
  3. Beidas, RS et al. Cogn Behav Pract. 2015;22(1):5-19.
  4. Altman, EG & Ostergaard, SD. Acta Psychiatr Scand. 2019;139(3):292-293.
  5. Cerimele, JM et al. Psychiatr Serv. 2019;70(5):396-408.
  6. STABLE National Coordination Council. Standards for bipolar excellence resource toolkit. 2015.
  7. Miklowitz, DJ et al. Bipolar Disord. 2012;14(2):185-197.

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