Bush-Francis Catatonia Rating Scale (BFCRS)

23 questions to assess the severity of catatonia.


The Bush-Francis Catatonia Rating Scale (BFCRS) is considered the gold standard for clinical and research purposes for catatonia screening, and diagnosis. The BFCRS was designed by Bush, Fink, Petrides, Dowling and Francis in 1996 and is based on descriptors of catatonia from the literature and motor signs identified in the DSM-III, IV and ICD-10 criteria. In Its present day form it covers all 12 criteria for a DSM V diagnosis of Catatonia. When compared against five other catatonia rating scales, the Bush-Francis Catatonia Rating Scale was the most widely used. It is regarded as a valid, reliable, and user-friendly catatonia rating scale.

The full scale is 23 items, with the first 14 questions comprising the screening instrument.. If ≥2 of the first 14 questions are positive, this indicates a positive screening and should prompt completion of 9 additional items. The rating scale takes roughly five minutes to be completed by a clinician and has been confirmed by multiple studies as highly reliable and sensitive for diagnosis. The sensitivity is 100%, but specificity predictions range from 75-100% as some of the signs are not specific to catatonia. The measure has a high inter-rater reliability, but test-retest reliability has not been proven as the natural course of catatonia waxes and wanes.


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The Bush-Francis Catatonia Rating Scale (BFCRS) calculator is created by QxMD.

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1. Immobility/stupor:

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Extreme hypoactivity, immobile, minimally responsive to stimuli.

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