CGI-SCHSchizophrenia Domain-Specific Global Impression
Positive
Negative
Depressive
Cognitive
Global
Rating Required
Select a severity rating for all five domains (positive, negative, depressive, cognitive, and global) to generate the full CGI-SCH summary.
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Assessment of symptom severity in patients with schizophrenia or related psychotic disorders
Brief clinician-rated monitoring of treatment response across symptom domains
Evaluating the impact of depressive and cognitive symptoms on the schizophrenia profile
Standardized global outcome measurement in clinical trials
How it Works
Scoring Logic
The CGI-SCH evaluates five domains on a 7-point scale (1=Normal/Not ill, 7=Extremely ill). Domains include Positive, Negative, Depressive, Cognitive, and Global symptoms.
Domains Evaluated
Positive Symptoms (Delusions, Hallucinations)
Negative Symptoms (Alogia, Avolition, Affective flattening)
Depressive Symptoms (Mood, Suicidality)
Cognitive Symptoms (Memory, Attention, Executive function)
Global Status (Overall severity)
Clinical Pearls
Key Clinical Points
The CGI-SCH assesses FIVE domains separately (positive, negative, depressive, cognitive, global) — this multi-domain approach is superior to the unipolar CGI for schizophrenia
The depressive domain is often overlooked in schizophrenia — the CGI-SCH specifically directs clinicians to evaluate depressive symptoms separately from negative symptoms
CGI-SCH scores ≥ 5 on any domain suggest the need for treatment optimization
The cognitive domain rating is a global clinical judgment — formal cognitive testing (BRIEF-A, MoCA) provides more precise assessment
Next Steps
Clinical Pathway
The Evidence
Primary Validation
CGI-SCH: a combined clinical global impression scale for use in schizophrenia.
Haro JM et al. • Acta Psychiatr Scand Suppl.. 2003;(416):32-40. Multi-centre validation (n=340) demonstrating high inter-rater reliability (kappa = 0.68–0.85 across domains) and sensitivity to clinical change in schizophrenia.
Origins & History
Development
The CGI-SCH was developed by Josep Maria Haro and an international group of schizophrenia researchers as part of the European Schizophrenia Outpatient Health Outcomes (SOHO) study. It was published in 2003 to address the limitation of the unipolar CGI, which does not capture the multi-dimensional nature of schizophrenia symptoms. The CGI-SCH has been widely used in observational studies and pragmatic clinical trials.
Last Comprehensive Review: 2026-07-17