Protocol - Global Mental Status Screener - Older Children and Adolescents
Protocol Name from Source:
Children’s Global Assessment Scale (CGAS)
The Children’s Global Assessment Scale (CGAS) is an interviewer-administered instrument that uses all available information to assess the overall functioning of a child. The CGAS reflects the lowest level of functioning during a specified time period. The CGAS is separated into ten 10-point sections headed with a description of function (e.g., Doing Very Well, Doing Well). The scores ranges from 1 (most impaired) to 100 (healthiest), with scores of 70 or above indicating normal function.
Children’s Global Assessment Scale (CGAS)
PLEASE RECORD A CGAS SCORE EVEN IF THIS IS BASED ON YOUR MEMORY OF THE YOUNG PERSON’S FUNCTIONING AT THE TIME OF REFERRAL. THE DATE OF RATING IS REQUIRED ONLY IF THIS WAS RECORDED CLOSE TO THE TIME OF THE ‘INDEX’ REFERRAL.
DATE OF CGAS RATING:
(IF RECORDED CLOSE TO TIME OF ‘INDEX’ REFERRAL)
OR FROM MEMORY
(PLEASE INDICATE AS APPROPRIATE)
DOING VERY WELL
Superior functioning in all areas (at home, at school, and with peers), involved in a range of activities and has many interests (e.g., has hobbies or participates in extracurricular activities or belongs to an organised group such as Scouts, etc.). Likeable, confident, everyday worries never get out of hand. Doing well in school. No symptoms.
Good functioning in all areas. Secure in family, school, and with peers. There may be transient difficulties and "everyday" worries that occasionally get out of hand (e.g., mild anxiety associated with an important exam, occasionally "blow-ups" with siblings, parents, or peers).
DOING ALL RIGHT - minor impairment
No more than slight impairment in functioning at home, at school, or with peers. Some disturbance of behaviour or emotional distress may be present in response to life stresses (e.g., parental separations, deaths, birth of a sibling) but these are brief and interference with functioning is transient; such children are only minimally disturbing to others and are not considered deviant by those who know them.
SOME PROBLEMS - in one area only
Some difficulty in a single area, but generally functioning pretty well, (e.g., sporadic or isolated antisocial acts such as occasionally playing hooky, petty theft; consistent minor difficulties with school work, mood changes of brief duration, fears and anxieties which do not lead to gross avoidance behavior; self-doubts). Has some meaningful interpersonal relationships. Most people who do not know the child well would not consider him/her deviant but those who do know him/her well might express concern.
60 - 51
SOME NOTICEABLE PROBLEMS - in more than one area
Variable functioning with sporadic difficulties or symptoms in several but not all social areas. Disturbance would be apparent to those who encounter the child in a dysfunctional setting or time but not to those who see the child in other settings.
50 - 41
OBVIOUS PROBLEMS - moderate impairment in most areas or severe in one area
Moderate degree of interference in functioning in most social areas or severe impairment functioning in one area, such as might result from, for example, suicidal preoccupations and ruminations, school refusal and other forms of anxiety, obsessive rituals, major conversion symptoms, frequent anxiety attacks, frequent episodes of aggressive or other antisocial behavior with some preservation of meaningful social relationships.
40 - 31
SERIOUS PROBLEMS - major impairment in several areas and unable to function in one area
Major impairment in functioning in several areas and unable to function in one of these areas, i.e., disturbed at home, at school, with peers or in the society at large, e.g., persistent aggression without clear instigation; markedly withdrawn and isolated behaviour due to either mood or through disturbance, suicidal attempts with clear lethal intent. Such children are likely to require special schooling and/or hospitalisation or withdrawal from school (but this is not a sufficient criterion for inclusion in this category).
30 - 21
SEVERE PROBLEMS - unable to function in almost all situations
Unable to function in almost all areas, e.g., stays at home, in ward, or in bed all day without taking part in social activities OR severe impairment in reality testing OR serious impairment in communication (e.g., sometimes incoherent or inappropriate).
20 - 11
VERY SEVERELY IMPAIRED - considerable supervision is required for safety
Needs considerable supervision to prevent hurting others or self, e.g., frequently violent, repeated suicide attempts, OR to maintain personal hygiene OR gross impairment in all forms of communication, e.g., severe abnormalities in verbal and gestural communication, marked social aloofness, stupor, etc.
10 - 1
EXTREMELY IMPAIRED - constant supervision is required for safety
Needs constant supervision (24-hour care) due to severely aggressive or self-destructive behaviour or gross impairment in reality testing, communication, cognition, affect, or personal hygiene.
Specified time period: 1 month
CGAS SCORE =
Personnel and Training Required
Personnel should be trained in the administration of the Children’s Global Assessment Scale (CGAS). Additionally, investigators are encouraged to have quality control procedures (such as videotaping sessions, etc.) in place to maintain consistency across examiners.
|Average time of greater than 15 minutes in an unaffected individual||No|
|Specialized requirements for biospecimen collection||No|
Mode of Administration
There are also versions for adults and older adults.
November 28, 2017
A test to assess the respondent’s overall mental capability.
This measure quickly screens a variety of cognitive domains to determine a respondent’s general mental status. It can be used to detect impaired mental status caused by a variety of conditions, including head injury, stroke, infections, brain tumors, developmental defects, and neurodegenerative disorders such as Alzheimer’s disease.
The Children’s Global Assessment Scale (CGAS) was selected because it is a standard, widely used, validated protocol.
Process and Review
[link[phenx.org/node/103|Expert Review Panel 4]] (ERP 4) reviewed the measures in the Neurology, Psychiatric, and Psychosocial domains.
Guidance from ERP 4 included the following:
- Changed name of measure
- Added new protocol
- Created new data dictionary
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A Children’s Global Assessment Scale (CGAS). Archives General Psychiatry, 40(11), 1228-1231.
Goldstein, B. I., Lotrich, F., Axelson, D. A., Gill, M. K., Hower, H., Goldstein, T. R., Fan, J., Yen, S., Diler, R., Dickstein, D., Strober, M. A., Iyengar, S., Ryan, N. D., Keller, M. B., & Birmaher, B. (2015). Inflammatory markers among adolescents and young adults with bipolar spectrum disorders. Journal of Clinical Psychiatry, 76(11), 1556-1563.
Lundh, A., Kowalski, J., Sundberg, C. J., Gumpert, C., & Landén, M. (2010). Children’s Global Assessment Scale (CGAS) in a naturalistic clinical setting: Inter-rater reliability and comparison with expert ratings. Psychiatry Research, 177(1-2), 206-210.
|Variable Name||Variable ID||Variable Description||Version||dbGaP Mapping|