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Neurology · Psychiatry

Bush-Francis Catatonia Rating Scale calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Excitement

The first 14 items are the screen. Two or more of those 14 scored above 0 is a positive screen. The reported number is the sum of all 23 items, maximum 69. Excitement is extreme non-purposeful hyperactivity, not akathisia and not goal-directed agitation.

Immobility or stupor
Mutism
Staring
Posturing or catalepsy
Grimacing
Echopraxia or echolalia
Stereotypy
Mannerisms
Verbigeration
Rigidity

Increased tone through the movement. Do not score cogwheeling or a known tremor. Use the most rigid muscle group.

Negativism
Waxy flexibility
Withdrawal
Impulsivity
Automatic obedience
Mitgehen
Gegenhalten
Ambitendency
Grasp reflex
Perseveration
Combativeness
Autonomic abnormality

Parameters are temperature, blood pressure, pulse, respiratory rate, and sweating. One scores 1, two score 2, and three or more score 3. Do not count high blood pressure that matches known hypertension at baseline. Do not exclude it during acute illness.

Result

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Clinical inputs

  • Excitement
  • Immobility or stupor
  • Mutism
  • Staring
  • Posturing or catalepsy
  • Grimacing
  • Echopraxia or echolalia
  • Stereotypy
  • Mannerisms
  • Verbigeration
  • Rigidity
  • Negativism
  • Waxy flexibility
  • Withdrawal
  • Impulsivity
  • Automatic obedience
  • Mitgehen
  • Gegenhalten
  • Ambitendency
  • Grasp reflex
  • Perseveration
  • Combativeness
  • Autonomic abnormality

Primary source

Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996;93:129-136. PMID: 8686483. Item anchors were read from the University of Rochester Bush-Francis Catatonia Rating Scale. Items 1–12, 14–16, 22, and 23 are graded 0–3. Items 13 and 17–21 are absent (0) or present (3). The first 14 items are the screening instrument. Two or more of those 14 items scored above 0 is a positive screen. The reported number is the sum of all 23 items, maximum 69. (1996)

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