Adaption and validation of the Rwandese version of the Young Mania Rating Scale to measure the severity of a manic or hypomanic episode

TL;DR

This paper adapts and validates the Young Mania Rating Scale in Kinyarwanda for use in Rwanda to assess manic episodes in bipolar disorder patients.

Contribution

The study provides a culturally adapted and validated version of the YMRS for the Rwandese population.

Findings

The R-YMRS showed adequate internal consistency with a Cronbach’s alpha of 0.90.

Items 5, 9, and 11 had low loadings and are recommended for removal to improve the scale’s fit to a Rasch model.

The revised R-YMRS is deemed reliable and valid for clinical and research use in Rwanda.

Abstract

Bipolar Disorder is one of the most incapacitating diseases among young persons, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. Managing a manic episode and developing new and more effective treatment modalities requires sensitive and reliable instruments. This study aims to translate the English version of the YMRS questionnaire into Kinyarwanda, adapt it to the Rwandan context, and assess its validity.

The original English version of The Young Mania Rating Scale questionnaire was translated into Kinyarwanda. The translation process followed a standardized approach, including back-translation, cross-cultural adaptation, and final adjustments. A total of 130 inpatients with bipolar disorder in a manic episode from CARAES Ndera Teaching Hospital were included. The descriptive statistics and test–retest correlations were carried out, as well as the CFA for validation and Rasch-analysis.

The Rwandese version of The Young mania rating scale had an adequate internal consistency (Cronbach’s alpha = 0.90). Item 11 provided the lowest standardized loading in both ratings (0.51 and 0.55). The second lowest loading involved the highly correlated item pairs 5 & 9, with item 5 loading 0.51 in rating 1 and item 9 loading 0.57 in rating 2. The remaining loadings ranged from 0.59 to 0.79. This relatively narrow range indicated that a fit to a Rasch model was plausible if excluding item 11.

The findings demonstrate that the translated YMRS, the R-YMRS, can be used as a reliable and valid instrument for assessing mania in the Rwandese population in clinical and research settings. However, the results supported using an unweighted total score of 32 and removing items 5, 9, and 11. Studies on this revised scale with an added interview guide for less-trained clinical staff are recommended.