Clinical Global Impression-severity score as a reliable measure for routine evaluation of remission in schizophrenia and schizoaffective disorders

Pinna, Federica; Deriu, L; Diana, Enrica; Perra, Valeria; Randaccio, Rachele Pisu; Sanna, Lucia; Tusconi, Massimo; Carpiniello, Bernardo

doi:10.1186/s12991-015-0042-6

Cited by 36 publications

(24 citation statements)

References 36 publications

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“…16 In a study investigating the reliability of CGI-S for evaluating remission, a CGI-Schizophrenia Scale severity score ≤ 3 (mildly ill) corresponded to RSWG remission criteria. 17 In the constituent studies, scores at end-point on the CGI-I, the companion component of the CGI-S, supported our post hoc observations of improvement in global disease severity. Across each cariprazine dose that was evaluated, mean CGI-I scores at end-point were between much improved (CGI-I = 2) and minimally improved (CGI-I = 3) and significantly different than placebo in the bipolar disorder studies at week 3 (P < .001 each) [6][7][8] and in the schizophrenia studies at week 6 (P < .01 each).…”

Section: Categorical Cgi-s Improvement and Symptom Severitysupporting

confidence: 69%

“…In a study investigating the reliability of CGI‐S for evaluating remission, a CGI‐Schizophrenia Scale severity score ≤ 3 (mildly ill) corresponded to RSWG remission criteria 17. In our post hoc category shift analyses, significantly more cariprazine‐ than placebo‐treated patients with schizophrenia shifted to a category with end‐point CGI‐S scores ≤ 3 regardless of the level of baseline disease severity.…”

Section: Discussionmentioning

confidence: 68%

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Global improvement with cariprazine in the treatment of bipolar I disorder and schizophrenia: A pooled post hoc analysis

Durgam

Earley

et al. 2017

Int J Clin Pract

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SummaryIntroductionGlobal rating scale measures are useful for assessing the clinical relevance of patient change. Cariprazine, a dopamine D3 and D2 receptor partial agonist, is FDA‐approved for the adult treatment of acute manic/mixed episodes of bipolar I disorder and schizophrenia. Post hoc evaluations of Clinical Global Impressions‐Severity (CGI‐S) scores from the cariprazine pivotal trials in both indications were conducted.MethodsData from 3 bipolar mania and 3 schizophrenia trials were pooled by indication (bipolar disorder = 1033; schizophrenia = 1466). Cariprazine‐ and placebo‐treated patients were categorised by baseline CGI‐S scores; the proportion of patients who improved from more severe categories at baseline to less severe categories at end‐point was evaluated using a logistic regression model. Correlations between Young Mania Rating Scale and Positive and Negative Syndrome Scale total score changes and category shifts were also evaluated.ResultsIn both disease states, more cariprazine‐ than placebo‐treated patients had improved CGI‐S scores at end‐point; more placebo‐treated patients had worse end‐point scores. More cariprazine‐ vs placebo‐treated patients shifted from the extremely/severely ill to mildly ill/better category (bipolar disorder = 55% vs 36%, odds ratio [OR] = 2.1; P = .09; schizophrenia = 42% vs 18%, OR = 3.4, P<.01). ORs was statistically significant in favour of cariprazine in shifts from marked and moderate illness to borderline/normal in both indications (P < .05). Correlations between rating scale improvement and category shift were greatest in patients with extreme/severe baseline illness for bipolar disorder (−0.853) and schizophrenia (−0.677).ConclusionsPost hoc analyses showed that more cariprazine‐ than placebo‐treated patients with bipolar mania or schizophrenia had statistically significant and clinically meaningful CGI‐S improvement.

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Section: Categorical Cgi-s Improvement and Symptom Severitysupporting

confidence: 69%

Section: Discussionmentioning

confidence: 68%

Global improvement with cariprazine in the treatment of bipolar I disorder and schizophrenia: A pooled post hoc analysis

Durgam

Earley

et al. 2017

Int J Clin Pract

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“…The CGI-I is a seven point scale scoring from 1 (very much improved) to 7 (very much worse), with a score of 4 indicating no change. The CGI scales are validated for different psychiatric disorders (Berk et al, 2008;Pinna et al, 2015;Spielmans & McFall, 2006), but not specifically in older adults, although older populations are taken into account in one large study that adequately validated the CGI scales in an inpatient clinic, which showed good overall validity (Berk et al, 2008). We used a scoring guideline and a matrix with examples how to score outcomes in different disorders (Brodaty, Draper, & Low, 2003;Busner & Targum, 2007;Kadouri, Corruble, & Falissard, 2007;Spearing, Post, Leverich, Brandt, & Nolen, 1997).…”

Section: Clinical Global Impressions Of Improvement (Cgi-i)mentioning

confidence: 99%

Frailty, multimorbidity and functional status as predictors for health outcomes of acute psychiatric hospitalisation in older adults

Benraad

Disselhorst

Laurenssen

et al. 2018

Aging & Mental Health

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Objectives: Frailty, multimorbidity and functional decline predict adverse health outcomes in community dwelling older people and older patients in general hospitals. This study investigates whether these characteristics separately are independent predictors of health outcomes of acute psychiatric hospitalization. Methods: Observational study in a prospectively sampled cohort of older patients, consecutively admitted to a psychiatric hospital. On admission we assessed frailty (Frailty Index and walking speed); multimorbidity (Cumulative Index Rating Scale Geriatrics (CIRS-G)) and functional status (Barthel Index). We used the Clinical Global Impressions of Improvement scale (CGI-I) as the psychiatric outcome measure, and dichotomized discharge destination as overall outcome measure: favourable (able to return home or previous care level) or adverse (death, or move to higher level of residential care). Results: We included 120 patients, 74.6 years (±7.8). 52.5% of the patients was frail (FI !0.25). The mean level of the CIRS-G was 13.5 (5.4). Mean CGI-I at discharge was 2.8 (± 1.0), indicating moderate improvement in the psychiatric outcome. Neither FI, CIRS-G, nor Barthel scores were, independent of age, sex and diagnosis, associated with the CGI-I. FI was predictive for adverse discharge destination (OR 1.91, 95%CI 1.09-3.37 per 0.1), as were higher CIRS-G (OR 1.19 95%CI 1.06-1.34, per point) and lower walking speed (OR 1.35 95%CI 1.06-1.72 per 0.1 m/s). Conclusions: Half of our patients were frail and had a high level of multimorbidity. The FI, walking speed and multimorbidity did not predict improvement of psychiatric symptoms at discharge, but independently helped to predict adverse discharge destination.

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“…It comprises five items based on a 7-point Likert scale that focus on positive, negative, depressive, cognitive, and overall symptom severity. This scale is considered a simple and reliable measure to evaluate the clinical status and course of the disease during routine clinical practice [32]. The WHODAS 2.0 evaluates six domains of functioning as experienced in the previous 30 days: mobility, self-care, life activities, understanding and communicating, interpersonal interactions, and participation in society [33].…”

Section: Methodsmentioning

confidence: 99%

Once-Monthly Long-Acting Injectable Aripiprazole for the Treatment of Patients with Schizophrenia and Co-occurring Substance Use Disorders: A Multicentre, Observational Study

Szerman

Basurte-Villamor

Vega³

et al. 2020

Drugs - Real World Outcomes

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Aim To evaluate the efficacy and impact of long-acting injectable (LAI) aripiprazole in patients with schizophrenia with a coexisting substance use disorder (SUD). Patients and methods A multicenter, observational, descriptive and retrospective study was conducted in patients with a DSM-5 diagnosis of schizophrenia who had a coexisting SUD and were treated with LAI-aripiprazole. Disease severity was evaluated with the Clinical Global Impression (CGI) severity scale for schizophrenia, daily functioning and disability were evaluated with the World Health Organisation Disability Assessment Scale (WHODAS-2.0), and the severity of the addiction was evaluated with the Severity of Dependence Scale (SDS). Results The sample included 40 patients. Overall, after 6 months of treatment with LAI-aripiprazole at a dose of 400 mg/4 weeks in 77.5% of the patients, we observed significant improvement in the psychopathological symptoms, with a reduction of over 30% in the scores of the five CGI-severity scales. The WHODAS-2.0 mean (standard deviation) score was also significantly reduced from 57.6 (8.2) to 42.3 (4.3) points (p < 0.001). Regarding SUDs, after 6 months of treatment, substance use was stopped in 5 of the 9 patients with cocaine use disorder and in 3 of the 16 patients with alcohol abuse disorder. A significant reduction in the severity of the dependence was observed only in the subgroups of participants with cocaine and alcohol use disorders. Conclusion Our study suggests that once-monthly LAI-aripiprazole retains its antipsychotic efficacy in patients with schizophrenia and a coexisting SUD and could be useful for the management of cocaine or alcohol use disorders in this population.

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Clinical Global Impression-severity score as a reliable measure for routine evaluation of remission in schizophrenia and schizoaffective disorders

Cited by 36 publications

References 36 publications

Global improvement with cariprazine in the treatment of bipolar I disorder and schizophrenia: A pooled post hoc analysis

Global improvement with cariprazine in the treatment of bipolar I disorder and schizophrenia: A pooled post hoc analysis

Frailty, multimorbidity and functional status as predictors for health outcomes of acute psychiatric hospitalisation in older adults

Once-Monthly Long-Acting Injectable Aripiprazole for the Treatment of Patients with Schizophrenia and Co-occurring Substance Use Disorders: A Multicentre, Observational Study

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