The Clinical Global Impression–Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia

TLDR

To describe the development and validation of the Clinical Global Impression–Schizophrenia (CGI‑SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. The CGI‑SCH scale was adapted from the CGI scale and its concurrent validity, sensitivity to change, and inter‑rater reliability were evaluated by comparing it with PANSS and GAF and by having two clinicians assess all patients. In 114 patients, the CGI‑SCH showed strong correlations with PANSS and GAF (most >0.75), substantial inter‑rater reliability (ICC > 0.70 except depressive dimension 0.64), confirming it as a valid, reliable tool for assessing schizophrenia severity and treatment response.

Abstract

Objective: To describe the development and validation of the Clinical Global Impression–Schizophrenia (CGI‐SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. Method: The CGI‐SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter‐rater reliability, all patients were assessed by two clinicians. Results: Symptoms were assessed in 114 patients. Correlation coefficients between the CGI‐SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). Conclusion: The CGI‐SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.