Clinical Global Impression Scale--Corrections

ABSTRACTBackground: Clinical trials of aripiprazole, a recentl Food and Drug Administration-approved atypical antipsychotic, included elderly patients, but more data are needed on the effects of aripiprazole in this population, especially those with comorbid medical illnesses.Objective: To assess the response and safety of aripiprazole treatment in elderly patients with phrenia or schizoaffective disorder.Method: Data was obtained by retrospective review of medical records. Aripiprazole was used to treat 10 elderly hospitalized patients between 62 and 85 years of age who manifested signs of psychosis related to schizophrenia or schizoaffective disorder. All patients had been treated previously with atypical and classic antipsychotics. Response was assessed by clinical observation of patients' behavior and Clinical Global Impression Scale assigned retrospectively.Results: Seven patients responded to treatment, two did not respond, and one had a partial response. The mean Clinical Global Impression Scale scores improved from 6 (severely ill) at baseline to 2.3 (much improved) at discharge. Treatment was discontinued in the two patients who did not respond. Of the seven patients who responded, four presented with positive symptoms and showed significant improvement while three presented with positive and negative symptoms and both symptoms improved significantly. Four patients had preexisting extrapyramidal symptoms (EPS) and these symptoms decreased in three patients. In addition, two patients were able to discontinue antiparkinson medications. One patient who had severe tardive dyskinesia showed significant improvement in the dyskinetic symptoms. Four patients showed postural hypotension (without clinical symptoms) which resolved over time without treatment. Six patients showed a mean weight loss of 5.2 lbs. No adverse consequences occurred when divalproex sodium, carbamazepine, clonazepam or citalopram were given concurrently.Conclusion: The reduction of both positive and negative symptoms of schizophrenia and the lack of significant EPS, tardive dyskinesia, sedation, weight gain, anticholinergic effects, and QTc prolongation gives preliminary indication that aripiprazole may be a safe and effective medication for elderly patients with schizophrenia or schizoaffective disorder.

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264 – Validation of a clinical global impression scale for aggression (CGI-A) in a sample of 558 psychiatric patients

Schizophrenia Research ◽

10.1016/j.schres.2007.12.331 ◽

2008 ◽

Vol 98 ◽

pp. 142

Author(s):

C.G. Huber ◽

M. Lambert ◽

D. Naber ◽

A. Schacht ◽

H.-P. Hundemer ◽

...

Keyword(s):

Clinical Global Impression ◽

Psychiatric Patients ◽

Clinical Global Impression Scale

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Video Clinical Global Impression Scale in Obsessive Compulsive Disorder Interview

PsycTESTS Dataset ◽

10.1037/t29279-000 ◽

2011 ◽

Author(s):

Abderrahmane Bourredjem ◽

◽

Antoine Pelissolo ◽

Jean-Yves Rotge ◽

Nematollah Jaafari ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Clinical Global Impression ◽

Obsessive Compulsive ◽

Clinical Global Impression Scale ◽

Compulsive Disorder

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Development of a clinical global impression scale for fatigue

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2011.12.001 ◽

2012 ◽

Vol 46 (3) ◽

pp. 370-374 ◽

Cited By ~ 14

Author(s):

Steven D. Targum ◽

Howard Hassman ◽

Maria Pinho ◽

Maurizio Fava

Keyword(s):

Clinical Global Impression ◽

Clinical Global Impression Scale

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S246. THE EFFECT OF INCORRECT SCALE ADMINISTRATION ON DATA QUALITY IN SCHIZOPHRENIA CLINICAL TRIALS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.312 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S132-S132

Author(s):

Alan Kott ◽

David Daniel

Keyword(s):

Clinical Trials ◽

Clinical Global Impression ◽

Primary Outcome Measure ◽

Primary Efficacy ◽

Double Blind ◽

Clinical Global Impression Scale ◽

Primary Efficacy Outcome ◽

Pooled Data ◽

Efficacy Outcome ◽

Time Stamps

Abstract Background The availability of date and time stamps of interview start times on eCOA systems permits monitoring and documentation of the order of administration of scales and instruments at each visit. The Clinical Global Impression Scale (CGI) is a holistic instrument that synthesizes all information available from the subject, caregivers, medical notes, etc. and is therefore typically required to be rated last at a particular visit. In the current retrospective analysis of double blind eCOA collected schizophrenia data pooled from multiple clinical trials we assessed the percent of visits where CGI was not administered last among other efficacy assessments. Additionally we assessed whether the inappropriate administration order of Clinical Global Impression Scale was associated with discrepancies in the data and change from baseline between the CGI and the primary efficacy outcome. Methods Available eCOA data were pooled from schizophrenia double blind, placebo controlled clinical trials. Within the data, we identified those visits where the CGI was not administered last among other efficacy assessments (inappropriate administration order). Within each trial we identified as discordant those data where the actual primary efficacy score or its change from baseline differed by at least two standard deviations from the expected score after linear regression. For this procedure the CGI- S score used as a predictor and the primary efficacy outcome as dependent variable. Logistic regression was then used on pooled data to explore whether the incorrect order of CGI administration increased the odds of discordant ratings between the CGI and primary outcome measure. Results The dataset consisted of 5,784 paired ratings of the CGI and the primary efficacy outcome. Among these, a total of 4,628 visits allowed to calculate change from baseline. Inappropriate order of CGI administration was identified in a total of 443 visits (7.7% of all visits). Discrepancies between CGI-S and the primary efficacy outcome were identified in 292 visits (5.1% of data) and discrepancies between change from baseline in CGI-S and in the primary efficacy outcome were observed in 249 cases (5.3% of data). The presence of incorrectly administered CGI increased the odds of raw score discrepancy 1.6x (95%CI 1.1–2.4), and the odds of discrepancy in change from baseline 1.8x (95%CI 1.2–2.7), both significant with p <0.01. Discussion Our data indicate a relatively large percent of visits suffer from an incorrect scale administration order. We have previously explored a number of sources of possible noise in schizophrenia clinical trials. Current analyses identified a significant effect of incorrect scale administration on the presence of between scale discordances. Such findings indicate that order of CGI administration should be mandated in schizophrenia clinical trials and enforced by eCOA platforms. Additionally, violations to correct scale administration should be monitored through analytic programs and acted upon in case of repeated occurrences at the rater or site level.

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Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

Psychological Medicine ◽

10.1017/s0033291703007414 ◽

2003 ◽

Vol 33 (4) ◽

pp. 611-622 ◽

Cited By ~ 154

Author(s):

T. I. ZAIDER ◽

R. G. HEIMBERG ◽

D. M. FRESCO ◽

F. R. SCHNEIER ◽

M. R. LIEBOWITZ

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Anxiety Disorders ◽

Social Anxiety Disorder ◽

Clinical Global Impression ◽

Severity Of Illness ◽

Anxiety Symptoms ◽

Self Report ◽

Clinical Global Impression Scale ◽

Additional Variance

Background. The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders.Method. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment.Results. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms.Conclusions. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.

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