Objective:  To describe the development and validation of the Clinical Global Impression–Schizophrenia (CGI‐SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. Method:  The CGI‐SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter‐rater reliability, all patients were assessed by two clinicians. Results:  Symptoms were assessed in 114 patients. Correlation coefficients between the CGI‐SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). Conclusion:  The CGI‐SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.

Women with schizophrenia and broken marriages in India are disabled and stigmatised not only by the illness, but by the social attitudes to marital separation and divorce. We interviewed caregivers of 75 such women attending mental health facilities in Chennai in an attempt to understand their perceptions, attitudes and concerns about the future of their wards. Burden on the families was assessed using the Burden Assessment Schedule developed by us. Most families expressed intense distress and were especially concerned about the long-term future and security of these women. Care of the children of these women was an additional problem, in the face of total lack of any financial support from the husbands. The various sociocultural factors modulating the scene are also discussed.

This is a qualitative study of 76 women with schizophrenia whose marriages had broken. The sample was drawn from three different centres. Using qualitative methods of exploration, information regarding their illness, the marriage and its separation and the various consequences of this event was gathered. Many of them had not separated legally and were not receiving any maintenance from their husbands. Their concerns centred around their future, the fact they would be a burden to their ageing parents and in some cases about their children. Stigma attached to separation was as poignant as that of being mentally ill, if not more. However, a striking aspect was that even after several years of separation, these women still harboured a lot of hope that they would be able to reunite with their husbands.

No abstract

No abstract