Global assessment of functioning and associated factors in psychiatric inpatients: a retrospective study

Abstract

Objective: Axis V in the DSM classification system uses The Global Assessment of Functioning Scale (GAF) to assess the levels of functional impairment due to by Axis I and Axis II disorders. However, GAF considers social, occupational and psychological functioning as a whole and therefore leading to a rapid decrease in functioning scores as far as the high psychopathology levels are concerned. In this study, we tested our hypothesis that the GAF scores mainly reflect the type and severity of psychopathology. Methods: The hospital records of 100 psychiatric inpatients were examined retrospectively. All the patients have been administered by GAF and some other scales at the time of admission and discharge. A statistical analysis was performed to evaluate the relationships between GAF scores and demographic and clinical variables. Results: A negative correlation was found between GAF scores and the scores of Brief Psychiatric Rating Scale and Clinical Global Impression at the time of admission. The GAF scores of patients with psychotic disorders were much lower when compared to patients with other diagnosis. Furthermore, it was found that being male, low educated, unemployed and having had long length of stays and numerous hospitalizations were associated with lower functioning levels. The GAF scores obtained at the time of discharge were significantly higher than the scores obtained at the time of admission. Discussion: Our findings are consistent with other studies indicating that GAF scores are associated with the type and severity of symptoms rather than social and occupational functioning. GAF is a useful tool in measuring treatment effects and monitoring progress. However, it has some limitations as far as measuring longer term functioning. (Anatolian Journal of Psychiatry 2012; 13:198-204)