Reliability, Validity, Factor and Discrimination Power Analysis of Young Mania Rating Scale among Unipolar, Bipolar Depression and Healthy People

Document Type : Original Article


1 Associate Professor of Psychiatry.Department of Psychiatry, Behavioral Sciences Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Ph.D. Student of Psychology.Department of Psychology, Faculty of Educational Sciences and Psychology, Isfahan University, Isfahan, Iran.

3 Master of Science in Clinical Psychology.Department of Psychiatry, Psychiatric Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Master of Science in Psychology.Department of Psychiatry, Behavioral Sciences Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.


Background and Objective: Unipolar depression disorder is different from bipolar depression disorder base on both phenomenology and biology. Discrimination of these two disorders in depression phase is a little difficult needing precise interview and suitable instrument. The goal of this study was to determine reliability, validity and factor and discrimination power analysis of young mania rating scale (YMRS).
Subjects and Methods: Three hundred and sixty seven people (120 bipolar depression disorder, BMD, 126 major depression disorder, MDD and 121 healthy people) from Medical University of Isfahan’s clinical centers and private clinics were participated in this study.  We used Young Mania Rating Scale, Bipolar Depression Rating Scale, Hamilton Depression Rating Scale and Beck Depression Inventory for gathering data, then analyzed them using Pierson Correlation, factor analysis and discrimination power analysis.
Results: YMRS had a high internal consistency (a=0.82) in Iranian population and it also showed a high concurrent validity with mixed subscale of BDRS (r=0.74.5). Factor analysis showed three factors named hyperactivity, high risk behavior and prognosis based on DSM-5 criteria for BMD. The best clinical cut of point was 7.5 with sensitivity of 62.5% and specificity of 89% to distinguish unipolar depression disorder from bipolar depression disorder.
Conclusion: Persian version of YMRS has good psychometric characteristics and has an acceptable power analysis for discrimination between BMD from MDD.


1- American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th, DSM-5. Translated by Farzin Rezaei, Ali Fakhraei, Atoosa Farmand, Ali Niloufari, Janet Hashemi & Farhad Shamlo. Tehran: Arjmand publication; 2103 (Persian).
2-Nussbaum A. The pocket guide to the DSM-5 diagnostic exam, translated by Farzin Rezaei & AliAkbar Froghi. Tehran: Arjmand Publication; 2013 (Persian).
3-Ganji M. Essentials of DSM-5 changes. Tehran: Savalan publication; 2014 (Persian).
4-Sadock BJ, Sadock VA. & Ruiz P. Synopsis of psychiatry: behavioral sciences/ clinical psychiatry. New York: Wolter Kluwer; 2015.
5-Sajatovic M, & Raminez L. Rating Scale in Mental Health. Hadsun: Lexi-Comp, Inc; 2001.
6-Young RC, Biggs JT, Ziegler VE, & Meyer DA. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry. 1978; 133: 429-3.
7-Karadag F, et al. Reliability and validity of Turkish translation of Young Mania RatingScale.TurkishPsikiyatriDergisi. 2002; 13(2): 107-14.
8-Lam RW, Michalak EE, & Swinson, RP. Assessment scales in depression, mania and anxiety, first published. Abingdon: Informa; 2005..
9-Barekatin M, Tavakkoli M, Molavi H, Maroofi M, & Salehi M. (2007). Normality, reliability and validity of Young Mania Rating Scale.  Journal of Psychology. 2007; 2: 150-167 (Persian).
10-Dozois DJA, & Uobson KS. A psychometric evaluation of the Beck depression inventory-II. Psychol Assess. 1998; 10(2): 83-9.
11-Beck AT, Strer RA, & Brawn GK. Manual of the BDI-II. San Antonio, TX: Psychological Corporation; 1996.
12-Ebrahimi A, Barekatin M, Bornamanesh A, & Nasiri H. Psychometric characteristics of Persian form of BDRS among patients and normal people. Iranian Journal of Psychiatry and Clinical Psychology. 2015; 21(1): 60-68 (Persian).
13-Hamilton M. A rating scale for depression.Journal of Neurology, Neurosurgery and Psychiatry. 1960; 23: 56-62.
14-Ballesteros J, Bobes J, &;Bulbena A. Sensitive to change, discriminative  performance  and  cut  off  criteria  to define  remission  for  embedded  short  scale  of  the Hamilton  depression  rating  scale.  J  Affect Disord. 2007; 102(3): 93-9.
15-Ebrahimi A, Neshatdoost HT, Mousavi SG, Asadollahi GA, & Nasiri H. Controlled  randomized  clinical  trial  of spirituality integrated psychotherapy (SIPT), cognitive-behavioral  therapy  (CBT)  and  medication  intervention on depressive symptoms and dysfunctional attitudes in patients  with  dysthymic  disorder.  Adv Biomed Res. 2013; 2(53): 1-7 (Persian).
16-Berk M, Malh, GS, Cahill C, Carman AC, Hadzi-Pavlovic D, & Hawkins MT, et al. The bipolar depression rating scale (BDRS): Its development, validation and utility. Bipolar Disord. 2007; 9(6): 571-9.
17-Poolsup N, et al. Measuring mania and critical appraisal of rating scales. Journal of Clinical and Pharmacological Therapy. 1999; 24: 433-443.
18-Shabani A, Akbari M, & Dadashi M. Reliability and validity of the bipolar depression rating scale on an Iranian sample. Arch Iran Medicine. 2010; 13(3): 217-22.
19-Young RC, Biggs JT, Ziegler VE, & Meyer DA. Young Mania Rating Scale. In:  Handbook of Psychiatric Measures. Washington, DC: American Psychiatric Association; 2000, p. 540-542.
20-Colom F, & Vieta E. Spanish version of a scale for the assessment of mania: Validity and reliability of the Young Mania Rating Scale. MedicinaClinica (Barc). 2002; 119(10): 366-71.
21-Favre S, et al. Translation and validation of a French version of the Young Mania Rating Scale. L Encephale. 2003; 29(6): 499-505.
22-Youngstrom EA, Danielson CK, Findling RL, Gracious BL, & Calabrese JR. Factor structure of the Young Mania Rating Scale for use with youths ages 5 to 17 years. J Clin Child AdolescPsychol. 2002; 31(4): 567-72.
23-Youngstrom EA, Genzlinger JE, Egerton GA, & Van Meter AR. Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania. Archives of Scientific Psychology. 2015; 3(1): 112.