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CGI
Corso: Basi Dell'Assistenza infermieristica - 2182 (040789)
35 Documenti
Gli studenti hanno condiviso 35 documenti in questo corso
Università: Università degli Studi di Bari Aldo Moro
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Rating Clinician-rated
Administration time Varies with familiarity with
patient
Main purpose To provide a global rating of illness
severity, improvement and response to treatment
Population Adults
Commentary
Amongst the most widely used of extant brief assessment
tools in psychiatry, the CGI is a 3-item observer-rated
scale that measures illness severity (CGIS), global
improvement or change (CGIC) and therapeutic response.
The illness severity and improvement sections of the
instrument are used more frequently than the therapeutic
response section in both clinical and research settings. The
Early Clinical Drug Evaluation Program (ECDEU) ver-
sion of the CGI (reproduced here) is the most widely used
format, and asks that the clinician rate the patient relative
to their past experience with other patients with the same
diagnosis, with or without collateral information. Several
alternative versions of the CGI have been developed, how-
ever, such as the FDA Clinicians’ Interview-Based
Impression of Change (CIBIC), which uses only informa-
tion collected during the interview, not collateral. The
CGI has proved to be a robust measure of efficacy in
many clinical drug trials, and is easy and quick to admin-
ister, provided that the clinician knows the patient well.
Scoring
The CGI is rated on a 7-point scale, with the severity of
illness scale using a range of responses from 1 (normal)
through to 7 (amongst the most severely ill patients).
CGI-C scores range from 1 (very much improved)
through to 7 (very much worse). Treatment response
ratings should take account of both therapeutic efficacy
and treatment-related adverse events and range from 0
(marked improvement and no side-effects) and 4
(unchanged or worse and side-effects outweigh the thera-
peutic effects). Each component of the CGI is rated sepa-
rately; the instrument does not yield a global score.
Versions
CGI for bipolar disorder (CGI-BD), FDA Clinicians’
Interview-Based Impression of Change (CIBIC),
Clinicians’ Interview-Based Impression of Change-Plus
(CIBIC+), NYU CIBIC+, Parke-Davis Pharmaceuticals
Clinical Interview-Based Impression (CIBI); the CGI has
been translated into most languages.
Additional references
Leon AC, Shear MK, Klerman GL, Portera L,
Rosenbaum JF, Goldenberg I. A comparison of
symptom determinants of patient and clinician global
ratings in patients with panic disorder and depression. J
Clin Psychopharmacol 1993; 13(5):327–31.
Spearing MK, Post RM, Leverich GS, Brandt D, Nolen
W. Modification of the Clinical Global Impressions
(CGI) Scale for use in bipolar illness (BP): the CGI-BP.
Psychiatry Res 1997; 73(3):159–71.
Zaider TI, Heimberg RG, Fresco DM, Schneier FR,
Liebowitz MR. Evaluation of the clinical global
impression scale among individuals with social anxiety
disorder. Psychol Med 2003; 33(4):611–22.
Address for correspondence
Not applicable – the CGI is in the public domain.
125
Clinical Global Impression (CGI)
Reference: Guy W, editor. ECDEU Assessment Manual for Psychopharmacology. 1976.
Rockville, MD, U.S. Department of Health, Education, and Welfare