title: Are GAF scores reliable in routine clinical use?
abstract: OBJECTIVE
  The Global Assessment of Functioning (GAF) scale has been considered as a reliable tool. However, most studies of GAF reliability have been based on special conditions, such as prior training and test awareness. This study takes a different approach investigating inter-rater reliability of GAF scores in a routine clinical context.
  
  
  METHODS
  Eighty-two consecutively admitted acute psychiatric patients were rated according to routine department procedures and by two researchers at admission and discharge. Intraclass correlations (ICC) were computed using two-way mixed models.
  
  
  RESULTS
  Inter-rater reliability between routine scores and research scores were low (ICC coefficients between r = 0.39 and 0.59). Inter-rater reliability between the two researchers were excellent (ICC coefficients r = 0.81 and 0.85).
  
  
  CONCLUSIONS
  Inter-rater reliability of GAF scores in a routine clinical context seems to be insufficient.
authors.affiliation: Department of Acute Psychiatry, Ullevål University Hospital, Oslo, Norway. tovatna@online.no
authors.forename: T
authors.initials: T
authors.lastname: Vatnaland
authors.forename: J
authors.initials: J
authors.lastname: Vatnaland
authors.forename: S
authors.initials: S
authors.lastname: Friis
authors.forename: S
authors.initials: S
authors.lastname: Opjordsmoen
mesh_terms: D006778:Hospitals, Psychiatric; D006801:Humans; D008505:Medical Staff, Hospital; D015588:Observer Variation; D010551:Personality; D011568:Psychiatric Nursing; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011570:Psychiatry; D015203:Reproducibility of Results; D013337:Students, Medical