title: Axis V - Global Assessment of Functioning scale (GAF), further evaluation of the self-report version.
abstract: OBJECTIVE
  The study aimed to examine agreement between patients' and professional staff members' ratings on the Global Assessment of Functioning scale (GAF).
  
  
  METHODS
  A total of 191 young adult psychiatric outpatients were included in a naturalistic, longitudinal study. Axis I and axis II disorders were assessed by means of the Structured Clinical Interview for DSM-IV. Before and after treatment, patients and trained staff members did a GAF rating. Agreement between GAF ratings was analyzed using the intra-class correlation coefficient (ICC).
  
  
  RESULTS
  The overall intra-class correlation coefficients before and after treatment were 0.65 and 0.86, respectively. Agreement in different axis I diagnostic groups varied, but was generally lower before treatment as compared to after treatment (0.50-0.66 and 0.78-0.90, respectively). Excessive psychiatric co-morbidity was associated with the lowest inter-rater reliability. Agreement, with respect to change in GAF scores during treatment, was good to excellent in all groups.
  
  
  CONCLUSIONS
  Overall, agreement between patients' and professionals' ratings on the GAF scale was good before and excellent after treatment. The results support the usefulness of the self-report GAF instrument for measuring outcome in psychiatric care. However, more research is needed about the difficulties in rating severely disordered patients.
authors.affiliation: Department of Neuroscience, Psychiatry UAS, University Hospital, ing 87, SE-751, 85 Uppsala, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Ramirez
authors.forename: L
authors.initials: L
authors.lastname: Ekselius
authors.forename: M
authors.initials: M
authors.lastname: Ramklint
mesh_terms: D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D055815:Young Adult