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Bush-Francis Catatonia Rating Scale Assessment Resources

Joshua Wortzel and Mark Oldham have developed the following educational resources on how to assess for catatonia using the Bush-Francis Catatonia Rating Scale (BFCRS) in collaboration with Andrew Francis.

BFCRS Training Manual & Coding Guide
Describes how to use the BFCRS and explains each item in detail.
Educational modules on using the BFCRS
Standardized patient videos and test questions with explanations.
Videos on scoring individual BFCRS items
These can also be accessed from the PDF version of the BFCRS.
BFCRS calculator with descriptions & videos (mobile optimized)
Developed in collaboration with Patrick Ying.

Overview of Catatonia
Assessment Resources

Dr. Oldham and Dr. Wortzel provide a brief introduction to the assessment resources available on this webpage.

Standardized Patient Training Videos

In the first of the four training videos below, we illustrate a full clinical assessment for the BFCRS in a standardized patient without catatonia. The subsequent three videos depict assessments of a standardized patient portraying catatonia's three common motoric subtypes. For each video, we provide a completed BFCRS form for how we score these assessments, along with key points for reference.

Normal Exam

This video features a standardized patient without catatonia to illustrate how to assess for all items on the BFCRS.

Clinical Assessment for the BFCRS:

Blank BFCRS form for scoring

Examples of Catatonia

Test materials

Below are videos of test patients A & B and corresponding forms A & B of a multiple-choice test, each with an answer key. You can also access the full 1-hour education course as it was originally presented, with pre-, post-, and 3-month assessments.

Standardized Test Patient A

Multiple choice test form A
Answer key to multiple choice test form A

Standardized Test Patient B

Multiple choice test form B
Answer key to multiple choice test form B

Additional Resources

Catatonia Information Center
Directed by Dr. Andrew Francis

Catatonia Resources hosted by University College London
Directed by Drs. Jonathan Rogers and Anthony David

So That’s What Catatonia Looks Like?
Narrative review of this project published in Psychiatric Times

Finding catatonia requires knowing what to look for
This MDedge News article provides guidance on converting BFCSI items to DSM-5-TR

References

Wortzel JR, Maeng DD, Francis A, Oldham MA. Evaluating the Effectiveness of an Educational Module for the Bush-Francis Catatonia Rating Scale. Acad Psychiatry. 2022;Jan 7 (online):10.1007/s40596-021-01582-0.

Wortzel JR, Maeng DD, Francis A, Oldham MA. Prevalent gaps in understanding the features of catatonia among psychiatrists, psychiatry trainees, and medical students. J Clin Psychiatry. 2021;82(5):21m14025.

Rogers JP, Oldham MA, Fricchione G, Northoff G, Wilson JE, Mann SC, Francis A, Wieck A, Wachtel LE, Lewis G, Grover S, Hirjak D, Ahuja N, Zandi MS, Young AH, Fone K, Andrews S, Kessler D, Saifee T, Gee S, Baldwin D, David AS. Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology. J Psychopharmacol. Online April 11, 2023.

Oldham MA. Describing the features of catatonia: A comparative phenotypic analysis. Schizophr Res. 2023; in press: 10.1016/j.schres.2022.08.002.

Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. II. Treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand. 1996; 93(2):137-143.

Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996;93(2):129-136.

Contact Us

Joshua Wortzel, MD, MPhil
Resident Physician in Psychiatry, PGY-4
Email

Mark Oldham, MD
Assistant Professor of Psychiatry
University of Rochester, Department of Psychiatry
Email