Download Flashcards for Anki, with three separate card types:

Scoring BFCRS Items

Items are scored 0, 1, 2, or 3

Except for several dichotomous items scored either 0 or 3
(Waxy Flexibility, Mitgehen, Gegenhalten, Ambitendency, Grasp Reflex, Perseveration)


Time and Date:

BFCRS Items 0 1 2 3
Immobility / Stupor
Posturing / Catalepsy
Echopraxia / Echolalia
Waxy Flexibility - -
Automatic Obedience
Mitgehen - -
Gegenhalten - -
Ambitendency - -
Grasp Reflex - -
Perseveration - -
Autonomic Abnormality

This html formatted table is easily pasted into spreadsheets like Excel or Sheets.

Alternatively, this Simple Text BFCRS is useful for pasting into EMRs, especially those like CPRS with monospaced typewriter fonts (e.g., Courier, Menlo, Consolas).

Descriptions of Scoring the BFCRS Items

This PDF Manual by the University of Rochester is useful to print and take into patient rooms while learning to score the BFCRS.

In-depth descriptions and examples of each item are available in the BFCRS Training Manual by the University of Rochester.

The tabulated information for scoring the BFCRS below is an even more concise reference.

BFCRS Items 0 1 2 3
Excitement Absent Excessive motion, intermittent Constant motion, hyperkinetic without rest periods Full-blown catatonic excitement, endless frenzied motor activity
Immobility / Stupor Absent Sits abnormally still, may interact briefly Virtually no interaction with external world Stuporous (psychological), non-reactive to painful stimuli
Mutism Absent Verbally unresponsive to majority of questions; incomprehensible whisper Speaks < 20 words in 5 minutes No speech
Staring Absent < 20 sec b/w shifting of attention, poor eye contact, repeated gaze, decreased blinking > 20 sec gaze held, occasionally shifts attention Fixed gaze, non-reactive
Posturing / Catalepsy Absent < 1 minute > 1 minute, < 15 minutes Bizarre posture, or mundane maintained ≥ 15 min
Grimacing Absent < 10 sec < 1 min Bizarre expression(s) maintained > 1 min
Echopraxia / Echolalia Absent Occasional Frequent Constant
Stereotypy Absent Occasional Frequent Constant
Mannerisms Absent Occasional Frequent Constant
Verbigeration Absent Occasional Frequent, difficult to interrupt Constant
Rigidity Absent Mild resistance Moderate resistance Severe resistance, cannot be repostured
Negativism Absent Mild resistance, occasionally contrary Moderate resistance, frequently contrary Severe resistance, continually contrary
Waxy Flexibility Absent Present
Withdrawal Absent Minimal PO intake/interaction < 1 day Minimal PO intake/interaction > 1 day No PO intake/interaction for ≥ 1 day
Impulsivity Absent Occasional Frequent Constant
Automatic Obedience Absent Occasional Frequent Constant
Mitgehen Absent Present
Gegenhalten Absent Present
Ambitendency Absent Present
Grasp Reflex Absent Present
Perseveration Absent Present
Combativeness Absent Occasionally strikes out, low potential for injury Frequently strikes out, moderate potential for injury Serious danger to others
Autonomic Abnormality Absent Abnormality of 1 parameter (exclude pre-existing hypertension) Abnormality of 2 parameters Abnormality of 3 or greater parameters


This material is for informational purposes only. It does not replace the advice or counsel of a doctor or healthcare professional. The authors of this website make every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.