The improved Clinical Global Impression Scale (iCGI): development and validation in depression

doi:10.1186/1471-244X-7-7

BMC Psychiatry

Volume 7

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Research article

The improved Clinical Global Impression Scale (iCGI): development and validation in depression

Alane Kadouri¹^,2^,3 , Emmanuelle Corruble¹^,2^,3 and Bruno Falissard¹^,2^,4

¹Inserm, U669, Paris, France

²Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France

³AP-HP, Hôpital de Bicêtre, Service de Psychiatrie, Le Kremlin-Bicêtre, France

⁴AP-HP, Hôpital Paul Brousse, Département de santé publique, Villejuif, France

author email corresponding author email

BMC Psychiatry 2007, 7:7doi:10.1186/1471-244X-7-7


Published:	6 February 2007

Abstract

Background

The Clinical Global Impression scale (CGI) is frequently used in medical care and clinical research because of its face validity and practicability. This study proposes to improve the reliability of the Clinical Global Impression (CGI) scale in depressive disorders by the use of a semi-standardized interview, a new response format, and a Delphi procedure.

Methods

Thirty patients hospitalised for a major depressive episode were filmed at T1 (first week in hospital) and at T2 (2 weeks later) during a 5' specific interview. The Hamilton Depressive Rating Scale and the Symptom Check List were also rated. Eleven psychiatrists rated these videos using either the usual CGI response format or an improved response format, with or without a Delphi procedure.

Results

The new response format slightly improved (but not significantly) the interrater agreement, the Delphi procedure did not. The best results were obtained when ratings by 4 independent raters were averaged. In this situation, intraclass correlation coefficients were about 0.9.

Conclusion

The Clinical Global Impression is a useful approach in psychiatry since it apprehends patients in their entirety. This study shows that it is possible to quantify such impressions with a high level of interrater agreement.