Clinical Global Impression

The Clinical Global Impression (CGI) rating scales are measures of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders.[1] Many researchers, while recognizing the validity of the scale, consider it to be subjective as it requires the user of the scale to compare the subjects to typical patients in the clinician experience.

Severity scale

The Clinical Global Impression – Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Possible ratings are:[1]

  1. Normal, not at all ill
  2. Borderline mentally ill
  3. Mildly ill
  4. Moderately ill
  5. Markedly ill
  6. Severely ill
  7. Among the most extremely ill patients

Improvement scale

The Clinical Global Impression – Improvement scale (CGI-I) is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention. and rated as:[1]

  1. Very much improved
  2. Much improved
  3. Minimally improved
  4. No change
  5. Minimally worse
  6. Much worse
  7. Very much worse

Efficacy index

The Clinical Global Impression – Efficacy Index is a 4×4 rating scale that assesses the therapeutic effect of treatment with psychiatric medication and associated side effects.[1]

Therapeutic effect Side effects
None Do not significantly interfere with patient's functioning Significantly interfere with patient's functioning Outweigh therapeutic effect
Marked — Vast improvement. Complete or nearly complete remission of all symptoms
Moderate — Decided improvement. Partial remission of symptoms
Minimal — Slight improvement which doesn't alter status of care of patient
Unchanged or worse

See also
  • Diagnostic classification and rating scales used in psychiatry
  • Outcomes research

References
  1. Guy, William (1976). "Clinical Global Impressions". ECDEU Assessment Manual for Psychopharmacology—Revised. Rockville, MD: U.S. Department of Health, Education, and Welfare; Public Health Service, Alcohol; Drug Abuse, and Mental Health Administration; National Institute of Mental Health; Psychopharmacology Research Branch; Division of Extramural Research Programs. pp. 218–222. OCLC 2344751. DHEW Publ No ADM 76–338 – via Internet Archive.
  • Guy, W. (2000). "Clinical Global Impressions (CGI) Scale, Modified". In Rush, John A.; Task Force for the Handbook of Psychiatric Measures (eds.). Handbook of Psychiatric Measures (1st ed.). Washington, DC: American Psychiatric Association. ISBN 978-0-89042-415-5. OCLC 43483679.

 This article incorporates public domain material from the National Institute of Mental Health document "ECDEU Assessment Manual for Psychopharmacology—Revised, 1976" by William Guy.

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