The clinical global impression scale and the influence of patient or staff perspective on outcome

“…36 The use of the CGI-C and CGI-S clinician rating efficacy measures have been previously compared. 37,38 Forkman et al reported comparable results between the CGI-C and CGI-S scales; however, they noted that both scales lacked congruence with patient ratings, and as a result, the authors suggested a variety of patient-and clinical-rated scales be incorporated in clinical trial designs.…”

Section: Discussionmentioning

confidence: 99%

Armodafinil for the Treatment of Excessive Sleepiness Associated with Mild or Moderate Closed Traumatic Brain Injury: A 12-Week, Randomized, Double-Blind Study followed by a 12-Month Open-Label Extension

Menn¹,

Yang

Lankford

2014

Journal of Clinical Sleep Medicine

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Objective: To evaluate the effi cacy and tolerability of armodafi nil in patients with excessive sleepiness following mild or moderate closed traumatic brain injury (TBI). S C I E N T I F I C I N V E S T I G A T I O N SE ach year, approximately 1.7 million people in the US experience a traumatic brain injury (TBI), 1 of which 75% are classifi ed as mild in severity.2 Sleep disturbances including obstructive sleep apnea, hypersomnia, insomnia, periodic limb movement, and narcolepsy have all been reported among patients with TBI.3-5 Excessive sleepiness-or the more broad condition of hypersomnia-is particularly common among post acute TBI patients, ranging from 25% to 53% depending on the defi nitions of the condition and assessments employed.4,6-8 This is considerably greater than the rate of excessive sleepiness reported in the general population (4.0% to 20.6%). 9The appreciable effects of sleep disorders on the TBI population are not fully known, although some evidence suggests that they may contribute to cognitive impairment, mood disturbance, and disrupt recovery or rehabilitation. 4,[10][11][12][13] Despite the high prevalence of hypersomnia in the TBI population, the literature is sparse regarding treatment recommendations. Recommended strategies include addressing any underlying medical or psychiatric conditions (e.g., nasal continuous positive

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“…3. Efficacy index: compares the patient's baseline condition to a ratio of current therapeutic benefit and severity of side effects (CGI-E) [8]. …”

Section: Methodsmentioning

confidence: 99%

An Interventional Study on the Clinical Usefulness and Outcomes of Electroconvulsive Therapy in Medication-Resistant Mental Disorders

Manhas

Mushtaq

Tarfarosh

et al. 2016

Cureus

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BackgroundResistance to recommended medications has been an issue in dealing with a number of psychiatric ailments, and it is showing up as an ongoing challenge for contemporary mental health experts. Resistant psychiatric disorders not only increase the morbidity of patients suffering from such severe conditions but also intensify the problems of their caretakers. This has vigorously started to cause the costs to increase for healthcare services. Thanks to electroconvulsive therapy (ECT), we now have an effective method that is proving to be a fruitful final course of action in this micro-epidemic of resistant psychiatric diseases. However, the medical literature of case reports or studies in this niche is scarce. Also, no such comprehensive study has been carried out in the Southeast Asian region to date for the assessment of the effectiveness of electroconvulsive therapy in patients with medication-resistant psychiatric disorders.AimTo assess the effectiveness of ECT in medication-resistant psychiatric patients at the post-ECT course, three-month follow-up, and six-month follow-up.Materials and methodsThe study was a prospective and interventional study (without controls) conducted in the Institute of Mental Health and Neurosciences (IMHANS), Srinagar, India. Fifty-six patients with pharmacotherapy-resistant psychiatric disorders were included in the study. The patients were assessed at the end of the ECT course, at the three-month follow-up, and at the six-month follow-up by the Clinical Global Impression (CGI), Montgomery Asberg Depression Rating Scale (MADRS), Young Manic Rating Scale (YMRS) and the Yale-Brown Obsessive Compulsive Scale (YBOCS). Improvement was defined with the help of the CGI subscale by comparing the position of the patient at admission to the projected condition with ECT.Statistical analysisAnalysis of Variance (ANOVA) was used for analysis of the quantitative data. For the pair-wise comparison of the groups, the post hoc tests were used. Pearson’s chi-square test was used for analysis of qualitative data. A p-value of < 0.05 was considered to be statistically significant, and all the data analysis was done using SPSS Version 20.0.ResultsThe CGI scale revealed that statistically significant improvement occurred in patients at the end of ECT course, at the three-month follow-up as well as at the six-month follow-up.ConclusionECT should be used for the treatment of pharmacotherapy-resistant psychiatric patients and the benefits can be seen even six months after an ECT course completion. Further work in this field should focus on educating the general public about the usefulness of ECT in the treatment of resistant mental illnesses. The myths related to the so-called psychiatric assault from ECT should be removed.

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The clinical global impression scale and the influence of patient or staff perspective on outcome

Cited by 116 publications

References 25 publications

Emotion suppression, not reappraisal, predicts psychotherapy outcome

Emotion suppression, not reappraisal, predicts psychotherapy outcome

Armodafinil for the Treatment of Excessive Sleepiness Associated with Mild or Moderate Closed Traumatic Brain Injury: A 12-Week, Randomized, Double-Blind Study followed by a 12-Month Open-Label Extension

An Interventional Study on the Clinical Usefulness and Outcomes of Electroconvulsive Therapy in Medication-Resistant Mental Disorders

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