Glasgow antipsychotic side-effects scale for Clozapine - development and validation of a clozapine-specific side-effects scale

Caroline Hynes*, Dolores Keating, Stephen McWilliams, Kevin Madigan, Anthony Kinsella, Ian Maidment, Celia Feetam, Richard J. Drake, Peter M. Haddad, Fiona Gaughran, Mark Taylor, Mary Clarke

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: The authors developed and validated a clozapine-specific side-effects scale capable of eliciting the subjectively unpleasant side-effects of clozapine.

METHODS: Questions from the original Glasgow Antipsychotic Side-effects Scale (GASS) were compared to a list of the most commonly reported clozapine side-effects and those with a significant subjective burden were included in the GASS for Clozapine (GASS-C). The original authors of the GASS and a group of mental health professionals from the UK and Ireland were enlisted to comment on the questions in the GASS-C based on their clinical experience. 110 clozapine outpatients from two sites completed the GASS-C, the original GASS and a repeat GASS-C. Statistical analyses were performed using SPSS for Windows version 19.

RESULTS: The GASS-C was shown to have construct validity, in that Spearman's correlation coefficient was 0.816 (p<0.001) with the original GASS, whilst Cohen's kappa coefficient was >0.77 (p<0.001) for one question and >0.81 (p<0.001) for remaining relevant questions. GASS-C was also shown to have strong test-retest reliability, in that Cronbach's alpha coefficient was >0.907 (p<0.001), whilst Cohen's kappa coefficient was >0.81 (p<0.001) for 12 questions and >0.61 (p<0.001) for the remaining four questions.

CONCLUSION: The GASS-C is a valid and reliable clinical tool to enable a systematic assessment of the subjectively unpleasant side-effects of clozapine. Future research should focus on how the scale can be utilised as a clinical tool to improve real-world outcomes such as adherence to clozapine therapy and quality of life.

Original languageEnglish
Article number6507
Pages (from-to)505-513
Number of pages9
JournalSchizophrenia Research
Volume168
Issue number1-2
Early online date12 Aug 2015
DOIs
Publication statusPublished - Oct 2015

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Clozapine
Antipsychotic Agents
Ireland
Mental Health
Outpatients
Quality of Life

Bibliographical note

*

Keywords

  • adverse effects
  • atypical antipsychotic agent
  • checklist
  • drug monitoring
  • questionnaire

Cite this

Hynes, Caroline ; Keating, Dolores ; McWilliams, Stephen ; Madigan, Kevin ; Kinsella, Anthony ; Maidment, Ian ; Feetam, Celia ; Drake, Richard J. ; Haddad, Peter M. ; Gaughran, Fiona ; Taylor, Mark ; Clarke, Mary. / Glasgow antipsychotic side-effects scale for Clozapine - development and validation of a clozapine-specific side-effects scale. In: Schizophrenia Research. 2015 ; Vol. 168, No. 1-2. pp. 505-513.
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Hynes, C, Keating, D, McWilliams, S, Madigan, K, Kinsella, A, Maidment, I, Feetam, C, Drake, RJ, Haddad, PM, Gaughran, F, Taylor, M & Clarke, M 2015, 'Glasgow antipsychotic side-effects scale for Clozapine - development and validation of a clozapine-specific side-effects scale', Schizophrenia Research, vol. 168, no. 1-2, 6507, pp. 505-513. https://doi.org/10.1016/j.schres.2015.07.052

Glasgow antipsychotic side-effects scale for Clozapine - development and validation of a clozapine-specific side-effects scale. / Hynes, Caroline; Keating, Dolores; McWilliams, Stephen; Madigan, Kevin; Kinsella, Anthony; Maidment, Ian; Feetam, Celia; Drake, Richard J.; Haddad, Peter M.; Gaughran, Fiona; Taylor, Mark; Clarke, Mary.

In: Schizophrenia Research, Vol. 168, No. 1-2, 6507, 10.2015, p. 505-513.

Research output: Contribution to journalArticle

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T1 - Glasgow antipsychotic side-effects scale for Clozapine - development and validation of a clozapine-specific side-effects scale

AU - Hynes, Caroline

AU - Keating, Dolores

AU - McWilliams, Stephen

AU - Madigan, Kevin

AU - Kinsella, Anthony

AU - Maidment, Ian

AU - Feetam, Celia

AU - Drake, Richard J.

AU - Haddad, Peter M.

AU - Gaughran, Fiona

AU - Taylor, Mark

AU - Clarke, Mary

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N2 - OBJECTIVE: The authors developed and validated a clozapine-specific side-effects scale capable of eliciting the subjectively unpleasant side-effects of clozapine.METHODS: Questions from the original Glasgow Antipsychotic Side-effects Scale (GASS) were compared to a list of the most commonly reported clozapine side-effects and those with a significant subjective burden were included in the GASS for Clozapine (GASS-C). The original authors of the GASS and a group of mental health professionals from the UK and Ireland were enlisted to comment on the questions in the GASS-C based on their clinical experience. 110 clozapine outpatients from two sites completed the GASS-C, the original GASS and a repeat GASS-C. Statistical analyses were performed using SPSS for Windows version 19.RESULTS: The GASS-C was shown to have construct validity, in that Spearman's correlation coefficient was 0.816 (p<0.001) with the original GASS, whilst Cohen's kappa coefficient was >0.77 (p<0.001) for one question and >0.81 (p<0.001) for remaining relevant questions. GASS-C was also shown to have strong test-retest reliability, in that Cronbach's alpha coefficient was >0.907 (p<0.001), whilst Cohen's kappa coefficient was >0.81 (p<0.001) for 12 questions and >0.61 (p<0.001) for the remaining four questions.CONCLUSION: The GASS-C is a valid and reliable clinical tool to enable a systematic assessment of the subjectively unpleasant side-effects of clozapine. Future research should focus on how the scale can be utilised as a clinical tool to improve real-world outcomes such as adherence to clozapine therapy and quality of life.

AB - OBJECTIVE: The authors developed and validated a clozapine-specific side-effects scale capable of eliciting the subjectively unpleasant side-effects of clozapine.METHODS: Questions from the original Glasgow Antipsychotic Side-effects Scale (GASS) were compared to a list of the most commonly reported clozapine side-effects and those with a significant subjective burden were included in the GASS for Clozapine (GASS-C). The original authors of the GASS and a group of mental health professionals from the UK and Ireland were enlisted to comment on the questions in the GASS-C based on their clinical experience. 110 clozapine outpatients from two sites completed the GASS-C, the original GASS and a repeat GASS-C. Statistical analyses were performed using SPSS for Windows version 19.RESULTS: The GASS-C was shown to have construct validity, in that Spearman's correlation coefficient was 0.816 (p<0.001) with the original GASS, whilst Cohen's kappa coefficient was >0.77 (p<0.001) for one question and >0.81 (p<0.001) for remaining relevant questions. GASS-C was also shown to have strong test-retest reliability, in that Cronbach's alpha coefficient was >0.907 (p<0.001), whilst Cohen's kappa coefficient was >0.81 (p<0.001) for 12 questions and >0.61 (p<0.001) for the remaining four questions.CONCLUSION: The GASS-C is a valid and reliable clinical tool to enable a systematic assessment of the subjectively unpleasant side-effects of clozapine. Future research should focus on how the scale can be utilised as a clinical tool to improve real-world outcomes such as adherence to clozapine therapy and quality of life.

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