The validity of the CGI severity and improvement scales as measures of clinical effectiveness suitable for routine clinical use.
OBJECTIVE
The Clinical Global Impression Scale (CGI) is established as a core metric in psychiatric research. This study aims to test the validity of CGI as a clinical outcome measure suitable for routine use in a private inpatient setting.


METHODS
The CGI was added to a standard battery of routine outcome measures in a private psychiatric hospital. Data were collected on consecutive admissions over a period of 24 months, which included clinical diagnosis, demographics, service utilization and four routine measures (CGI, HoNOS, MHQ-14 and DASS-21) at both admission and discharge. Descriptive and comparative data analyses were performed.


RESULTS
Of 786 admissions in total, there were 624 and 614 CGI-S ratings completed at the point of admission and discharge, respectively, and 610 completed CGI-I ratings. The admission and discharge CGI-S scores were correlated (r = 0.40), and the indirect improvement measures obtained from their differences were highly correlated with the direct CGI-I scores (r = 0.71). The CGI results reflected similar trends seen in the other three outcome measures.


CONCLUSIONS
The CGI is a valid clinical outcome measure suitable for routine use in an inpatient setting. It offers a number of advantages, including its established utility in psychiatric research, sensitivity to change, quick and simple administration, utility across diagnostic groupings, and reliability in the hands of skilled clinicians.
Berk
Michael
M
Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, Victoria, Australia.
Ng
Felicity
F
Dodd
Seetal
S
Callaly
Tom
T
Campbell
Shirley
S
Bernardo
Michelle
M
Trauer
Tom
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035843:Biomedical Research / Q000379:methods*; D003625:Data Collection / Q000379:methods; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry; D055815:Young Adult