What Is the Global Assessment of Functioning (GAF) Scale?

Check out this answer from Consensus:

The GAF scale is a valuable tool for assessing the overall functioning of individuals with mental health disorders. It provides a standardized method for clinicians to evaluate the impact of symptoms on daily life and to monitor the effectiveness of various treatments. Despite some limitations, such as its subjective nature, the GAF scale remains widely used in both clinical practice and research.

The Global Assessment of Functioning (GAF) scale is a numeric scale (0 through 100) used by mental health clinicians and physicians to subjectively rate the social, occupational, and psychological functioning of adults. The scale is designed to assess how much a person’s symptoms affect their day-to-day life.

Purpose and Use

The GAF scale is primarily used to evaluate the overall functioning of individuals with mental health disorders. It helps clinicians to:

• Assess the severity of mental illness.
• Track the progress of patients over time.
• Determine the impact of treatment interventions.

Scoring

The GAF scale ranges from 0 to 100, with higher scores indicating better functioning. The scale is divided into ten ranges, each describing a different level of functioning:

• 91-100: Superior functioning in a wide range of activities.
• 81-90: Absent or minimal symptoms.
• 71-80: If symptoms are present, they are transient and expectable reactions to psychosocial stressors.
• 61-70: Some mild symptoms or some difficulty in social, occupational, or school functioning.
• 51-60: Moderate symptoms or moderate difficulty in social, occupational, or school functioning.
• 41-50: Serious symptoms or any serious impairment in social, occupational, or school functioning.
• 31-40: Some impairment in reality testing or communication or major impairment in several areas.
• 21-30: Behavior is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment.
• 11-20: Some danger of hurting self or others or occasionally fails to maintain minimal personal hygiene.
• 1-10: Persistent danger of severely hurting self or others or persistent inability to maintain minimal personal hygiene.
• 0: Inadequate information.

Clinical Applications

The GAF scale is widely used in clinical settings to assess the impact of various treatments on patients with mental health disorders. For instance:

• Schizophrenia: Studies have shown that interventions such as cannabidiol (CBD) can lead to improvements in overall functioning as measured by the GAF scale1. Similarly, compliance therapy has been found to improve global functioning in schizophrenic patients6.
• Obsessive-Compulsive Disorder (OCD): The GAF scale has been used to measure the effectiveness of treatments like subthalamic nucleus stimulation, which has shown significant improvements in functioning8.
• Depression: In trials involving adolescents with major depressive disorder, the GAF scale has been used to track improvements in functioning over time5.

Research Findings

Several studies have utilized the GAF scale to measure treatment outcomes:

• Schizophrenia Treatments: A study comparing ziprasidone and haloperidol found no significant difference in GAF scores between the two drugs, indicating similar efficacy in improving overall functioning2.
• Educational Interventions: Structured educational interventions for schizophrenia patients have shown significant improvements in GAF scores, suggesting better overall functioning3.
• Self-Determination in Day Hospitals: Research on long-term day hospital users with schizophrenia indicated that regular self-determination did not lead to significant improvements in GAF scores, although some improvements in social functioning were noted4.