What is Clinical Global Impression (CGI) Scale and How Does it help Mental Health Professionals?

In the United States, nearly half of adults face mental illness at some part of their lives. Whether this mental illness is mild to severe depression, post-traumatic stress disorder from a life-changing event, generalized anxiety, or a more serious disorder, all people have a right to access quality mental health care.

However, as disorders that are more often than not invisible to the people around you, mental health is often overlooked as not important or is stigmatized. At Psych Associates of Maryland, we’re dedicated not only to breaking this stigma but to providing the highest caliber of mental health care in the region.

We do this by approaching treatment using trusted methods and caring practitioners who utilize spectacular tools in treatment. So what exactly is the CGI scale, and how can it help Psych Associates of Maryland provide better treatment? We’re here to break it down for you.

What is the CGI (Clinical Global Impression) Scale?

How This Common Treatment Efficacy Scale Works

The CGI Scale - of Clinical Global Impression - is a standardized assessment scale for determining the effects of mental health treatment among psychiatric patients. Though widely used in clinical psychopharmaceutical trials, the CGI Scale brings benefits to all levels of psychiatric treatment. The scale consists of three separate global subscales:

• Severity of Illness (CGI-S): The severity of illness subscale is designed to acquaint the patient’s severity of symptoms with those of other people experiencing the same mental ailment. The CGI-S rates this severity of a 1-7 scale, with (1) representing normal symptoms, meaning the patient is not ill. The highest on the scale, (7), represents patients among the most severely ill. Right in the middle at (4), a patient will be defined as moderately ill.
• Global Improvement (CGI-I): The global improvement subscale allows the practitioner to create a comparative improvement based on the baseline of the first test. These changes reflect how symptoms have or have no improves due to treatment. The 7-point CGI-I scale rates improvement with a (1) representing a ‘very much improved’ patient and (7) representing a patient who has become ‘very much worse’ due to treatment. The rating (4) represents a patient displaying no change from the treatment.
• Efficacy Index: The efficacy index helps practitioners to categorize the effects of treatment compared to the severity of the given side effect. This grid-shaped index uses the Y-axis to measure therapeutic effect - similar to the CGI-I scale, except for categorized into 4 streamlined segments for efficacy - and the X-axis that measures side effects. Side effects can range from none to being so severe that they outweigh the therapeutic benefits, leading practitioners to a decisive way of seeing if a medication or treatment is really worth it for the patient.

All measurements on the CGI-scale are relative not only to a global comparison of others facing mental health issues but to the experience of the practitioner his or herself. In other words, a practitioner can only assess and base ratings off of their own experiences and knowledge.

Pros and Cons of the CGI Scale

Is the CGI Scale Really a Good Basis for Defining Treatment Efficacy?

There are arguments among the mental health and scientific treatment about whether or not the clinical global impression scale is the best way to tackle measuring efficacy in mental health treatment.

An inherent issue behind treatment mental health issues is a simple fact that it is extremely difficult to quantify symptoms; you can take a patient’s temperature to figure out of they have a fever or measure their blood pressure, but mental health is extremely complicated and can be difficult to measure.

The CGI scale, along with other mental health proponents, allows the quantification of mental health treatment.

A primary underlying problem in the clinical global impression scale is its global application requiring comparison to other patients. Practitioners are required - based on a combination of education and fieldwork - to make a rating based solely on relative judgments of a person’s mental condition.

This relative scale is inherently flawed due to the nonexistence of suitable accuracy but does provide the benefits of forcing practitioners to apply valuable past experience to the treatment of patients in a clinical setting.

While subjective to a certain extent, the CGI scale is systematically designed to acknowledge the non-linear nature of mental illness and healing. Allowing for the open recording of the premise that sometimes it gets worse before it gets better and that mental health treatment isn’t ‘one size fits all,’ the CGI Scale reflects common values that, in essence, allow practitioners to provide better treatment.

How Does the CGI Scale Help Mental Health Professionals Provide Better Treatment?

Clinical Global impression Scale in Practice at Psych Associate of Maryland

The clinical global impression scale allows practitioners to provide more comprehensive mental health treatment by creating a quantifiable measurement of mental health symptoms and treatment efficacy. Practitioners can easily track symptoms and their improvement - or lack thereof - to evaluate whether or not the treatment is working.

Additionally, the efficacy index allows practitioners to make patient-first decisions that take into account the side effect of treatment. Allowing practitioners the see how the treatment effects the patient from a holistic standpoint helps the patient and practitioner make more informed decisions and get the patient's life back on track sooner.

Think it’s time you seek treatment for your own mental health? Get in touch with Psych Associates of Maryland - a leader in mental health in the Baltimore, Columbia, and Towson area - to learn how we can help you get back to feeling like yourself.