Bush–Francis Catatonia Rating Scale (BFCRS)
Document observed catatonic signs and dimensional severity; requires clinical interpretation
Reference information · Questionnaire
- Last content update
- 2026-10-26
- Clinical review
- Not independently reviewed
- Source jurisdiction
- See individual sources
- Coverage
- Questionnaire
| Field | Instrument context |
|---|---|
| Version | Original English 23-item order; Rochester BFCRS form and February 2022 coding manual |
| Population | Clinical assessment of suspected catatonia; not a patient self-report tool |
| Respondent | Trained clinician examination |
| Recall period | At least five-minute assessment; specify state or interval examination and use collateral information where required |
| Purpose | Document observed catatonic signs and dimensional severity; requires clinical interpretation |
Use the standardized BFCRS examination and coding manual. Observe spontaneous behavior, speech, eye contact and activity; assess postures, imitation, resistance, rigidity, automatic obedience, mitgehen, gegenhalten, ambitendency and grasp reflex using the manual’s examination procedure. Review intake and vital signs. The assessment requires at least five minutes, or the duration of the clinical examination if longer. State versus interval findings must be identified in the clinical record. Items such as withdrawal require collateral information about duration. Read the source manual for the complete examination and exclusion rules before rating.
Bush G, Fink M, Petrides G, Dowling F, Francis A (1996). Catatonia I: Rating scale and standardized examination. Acta Psychiatrica Scandinavica 93:129–136. Manual: Wortzel, Francis and Oldham; February 2022.
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Interpretation & limitations
- Severity total is the sum of all 23 ratings (0–69). The separate screening-sign count records presence among items 1–14 (0–14).
- Neither score establishes a diagnosis, severity category, treatment selection or safety. Clinical examination and context are required.
- The presence count treats each endorsed sign once, including items with only 0 and 3 anchors.
- Use the official standardized examination and training manual. Do not infer absence of a sign from missing observations.
- Different reproduced forms reorder items; this definition uses the official Rochester order consistently.
References · 4
- Official BFCRS item order, descriptions and anchors
- Official standardized examination and coding manual
- APA catatonia resource document; educational and clinical use context
- Permission and attribution · Official clinician assessment and educational resources developed with Andrew Francis and provided through Rochester; preserve source wording and attribution. These resources are described as free for educational and clinical use in the APA catatonia resource document.