THE CLINICIAN-ADMINISTERED RATING-SCALE FOR MANIA (CARS-M) - DEVELOPMENT, RELIABILITY, AND VALIDITY

There are currently seven raring scales available to assess manic symp tomatology. All, however, have some limitations that could restrict th eir clinical and research utility. To resolve these deficiencies the C linician-Administered Rating Scale for Mania (CARS-M) was developed an d normed on 96 patients with mixed diagnoses during baseline and follo wing treatment. Interrater reliability was established across multiple raters viewing 14 videotaped interviews and comparing agreement among individual items and total scores. Test-retest reliability was assess ed on 36 patients twice during baseline. The mean intraclass correlati on coefficient among five raters across items for each of the 14 patie nts was 0.81, and for total scores 0.93. Principal components analysis of items revealed two factors: mania, and psychosis. Test-retest reli ability was significant for both factors (range = 0.78 to 0.95). Inter nal validity, comparing each item with its respective total factor sco re, revealed significant correlations for all items. Correlation of CA RS-M total scores with mania rating scale (MRS) total scores was 0.94. Results indicate the CARS-M is both a reliable and valid measure of t he severity of manic symptomotology, which incorporates a number of me thodological improvements leading to greater precision and clinical ut ility.