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The severity of agitation is evaluated by using the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC), often referred to as PEC. Scoring ranges from 5 to 35, and a score 13 represents mild agitation; 19 moderate and 31 severe.
The Agitated Behavior Scale (ABS) was developed to assess the nature and extent of agitation during the acute phase of recovery from acquired brain injury. Its primary purpose is to allow serial assessment of agitation by treatment professionals who want objective feedback about the course of a patients agitation.
Mild: Agitated but cooperative. Moderate: Disruptive without danger. Severe: Excited delirium and/or dangerous to self and/or staff.
The degree of agitation can be assessed by observing 5 main symptom categories, based on the Positive and Negative Syndrome Scale-Excited Component (PEC) scale, a validated tool to measure the level of agitation. A helpful resource to identify signs of agitation and assess severity.
The most common subtypes include 1) PNAB, such as restlessness and pacing; 2) PAGB, such as hitting, grabbing onto people, pushing, and kicking; 3) verbally nonaggressive behavior (VNAB), such as complaining and constant requests for attention; and 4) verbally aggressive behavior (VAGB), such as cursing, verbal
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The Agitated Behavior in Dementia Scale (ABID) pro- vides a reliable and valid evaluation of both frequency of and caregiver reaction to common agitated behaviors experienced by individuals with dementia. It is brief, easy to administer, and focuses on observable behaviors.
Each item is rated from 1 (absent) to 4 (present to an extreme degree). Total scores of 21 points or below are classified as normal behavior, 2228 as mild agitation, 2935 as moderate agitation, and 3656 as severe agitation.

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