The Altman Self-Rating Mania Scale (ASRM) is a 5-item self-report questionnaire designed to assess the presence and severity of manic and hypomanic symptoms, most commonly in patients with bipolar disorder. Developed by Edward Altman and published in Biological Psychiatry in 1997, the ASRM evaluates five symptom domains: elevated/euphoric mood, increased self-confidence, decreased need for sleep, pressured speech, and psychomotor agitation. A total score of 6 or higher indicates a high probability of a manic or hypomanic episode. The scale is validated for adults and adolescents (ages 11 and older) and demonstrates strong correlation with clinician-rated measures including the Young Mania Rating Scale (YMRS, r = 0.72–0.80) and the Clinician-Administered Rating Scale for Mania (CARS-M, r = 0.77). Zentake’s digital ASRM auto-scores results instantly and integrates with your EMR workflow.
The ASRM consists of five items, each presenting five statements rated from 0 (symptom not present) to 4 (symptom present in severe degree). Patients select the one statement per item that best describes their experience over the past week. The total score is the sum of all five items, ranging from 0 to 20.
Clinical interpretation thresholds:
The ASRM is intended as a screening tool, not a diagnostic instrument. A positive screen should prompt a comprehensive clinical evaluation including structured diagnostic interviews.
Zentake automatically calculates the ASRM total score upon form submission, flags scores at or above the clinical cutoff, and stores results for longitudinal comparison across patient visits.
Step 1: Select the assessment. Choose the ASRM from your Zentake template library. The digital form includes all five validated items with the standard five-statement response format for each.
Step 2: Deliver to the patient. Send the ASRM to your patient via Zentake’s secure link, patient portal, tablet, or waiting-room kiosk. The scale is designed for self-administration and requires no clinical supervision.
Step 3: Patient completes the scale. The ASRM takes approximately one to two minutes to complete. Patients select the one statement per item that best describes how they have been feeling over the past week.
Step 4: Review auto-scored results. Zentake automatically sums all five items and compares the total against the clinical cutoff of 6. Scores at or above threshold are flagged in your dashboard for immediate review.
Step 5: Integrate with treatment planning. Use ASRM results alongside clinical observation, medication records, and mood charting. Zentake’s longitudinal tracking lets you compare scores across visits to assess treatment response and detect emerging manic episodes early.
Scoring: Paper ASRM requires manual review of five items, summing scores, and comparing against the cutoff threshold. Zentake auto-scores instantly and flags clinical thresholds automatically.
Completion time: Both paper and digital versions take one to two minutes. Digital eliminates clinician time spent scoring and transcribing results.
Delivery: Paper forms require printing and in-office distribution. Zentake delivers the ASRM remotely via secure link, enabling between-visit monitoring of manic symptoms.
Data storage: Paper forms must be manually filed or scanned. Zentake stores all responses in a HIPAA-compliant cloud database with instant retrieval.
Longitudinal tracking: Tracking mania severity over time on paper requires manual chart review. Zentake automatically displays ASRM score trends across visits.
Security: Paper forms risk loss and unauthorized access. Zentake uses encryption at rest and in transit with full audit logging.
Integration: Paper results require manual EMR entry. Zentake integrates directly with Elation and other EMR platforms for seamless documentation.
Cost: Paper forms incur ongoing printing and staff time costs. Zentake eliminates all paper-related expenses.
What does the ASRM measure?
The Altman Self-Rating Mania Scale measures five core symptoms of mania: elevated mood, increased self-confidence/grandiosity, decreased need for sleep, increased talkativeness/pressured speech, and increased motor activity/energy. It is primarily used to screen for and monitor the severity of manic and hypomanic episodes in bipolar disorder. Zentake’s digital version auto-scores and flags results for clinical review.
How do you score the ASRM?
Each of the five ASRM items is scored from 0 to 4 based on which statement the patient endorses. The five item scores are summed to produce a total score ranging from 0 to 20. A total score of 6 or higher suggests a high probability of a manic or hypomanic episode. Zentake calculates this automatically upon form submission.
How long does the ASRM take to complete?
The ASRM takes approximately one to two minutes to complete. Each of the five items requires the patient to select one of five statements, making it a very brief and practical screening tool for clinical use. Zentake’s digital format allows completion on any device.
Is the ASRM free to use?
The ASRM is freely available for clinical and research use. It was published in the scientific literature without licensing restrictions. Zentake provides a pre-built digital version of the ASRM included in all subscription plans.
What age group is the ASRM designed for?
The ASRM was originally developed and validated in adult psychiatric populations. It has also been adopted by the American Psychiatric Association as a Level 2 Cross-Cutting Symptom Measure for mania in both adults and children ages 11–17. Zentake supports administration across both age groups.
Who should administer the ASRM?
The ASRM is a self-report measure designed to be completed by the patient independently. It does not require clinical supervision or specialized training to administer. Zentake enables remote self-administration via secure digital link, allowing patients to complete the scale between appointments.
How often should the ASRM be administered?
For patients with bipolar disorder, the ASRM can be administered at every clinical visit or on a weekly basis during acute episodes to monitor symptom fluctuation. During maintenance phases, monthly or quarterly administration may be sufficient. Zentake’s scheduling features automate recurring administration.
Can the ASRM distinguish between mania and hypomania?
The ASRM identifies the presence and severity of manic symptoms but does not distinguish between full mania and hypomania. Higher scores indicate more severe symptoms, but the clinical distinction between mania and hypomania requires a comprehensive diagnostic evaluation including functional impairment and duration criteria.
1. Altman, E.G., Hedeker, D., Peterson, J.L., & Davis, J.M. (1997). The Altman Self-Rating Mania Scale. Biological Psychiatry, 42(10), 948–955.
2. Altman, E.G., Hedeker, D., Peterson, J.L., & Davis, J.M. (2001). A comparative evaluation of three self-rating scales for acute mania. Biological Psychiatry, 50(6), 468–471.
3. Fountoulakis, K.N., Samara, M., & Siamouli, M. (2014). Burning issues in the meta-analysis of pharmaceutical trials for depression. Journal of Psychopharmacology, 28(2), 106–117.
Last updated: March 2026
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