PMID- 12045311
OWN - NLM
STAT- MEDLINE
DCOM- 20020801
LR  - 20191210
IS  - 1075-2730 (Print)
IS  - 1075-2730 (Linking)
VI  - 53
IP  - 6
DP  - 2002 Jun
TI  - Global Assessment of Functioning ratings and the allocation and outcomes of 
      mental health services.
PG  - 730-7
AB  - OBJECTIVE: The Global Assessment of Functioning (GAF) is an integral part of the 
      standard multiaxial psychiatric diagnostic system. The purpose of including the 
      GAF in DSM-IV as a tool for axis V assessment is to enable clinicians to obtain 
      information about global functioning to supplement existing data about symptoms 
      and diagnoses and to help predict the allocation and outcomes of mental health 
      treatment. The purpose of this study was to examine the value of the GAF as part 
      of a systemwide program for monitoring the allocation and outcomes of mental 
      health care services. METHODS: Clinicians used the GAF to assess global 
      functioning among 9,854 patients with psychiatric or substance use disorders, or 
      both, who were already participating in an outcomes monitoring program of the 
      Department of Veterans Affairs. A longitudinal prospective follow-up design was 
      used. RESULTS: Patients' clinical diagnoses and symptoms were stronger predictors 
      of GAF ratings than was their social or occupational functioning. GAF-rated 
      impairment was associated with the provision of inpatient or residential care and 
      outpatient psychiatric care, but patients with greater levels of impairment did 
      not receive more treatment. GAF ratings were only minimally associated with 
      treatment outcomes. No robust associations were found between GAF ratings and 
      outcomes as assessed by clinician interview or by patients' self-report at 
      follow-up. CONCLUSIONS: Including GAF ratings in a program for predicting the 
      allocation and outcomes of mental health care is of questionable value. Research 
      is needed to determine whether systematic training and ongoing validity checks 
      would enhance the contribution of the GAF in monitoring service use and outcomes.
FAU - Moos, Rudolf H
AU  - Moos RH
AD  - Center for Health Care Evaluation, Program Evaluation and Resource Center of the 
      Veterans Affairs Health Care System, Stanford University, Palo Alto, California, 
      USA. bmoos@stanford.edu
FAU - Nichol, Aran C
AU  - Nichol AC
FAU - Moos, Bernice S
AU  - Moos BS
LA  - eng
GR  - AA-12718/AA/NIAAA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Psychiatr Serv
JT  - Psychiatric services (Washington, D.C.)
JID - 9502838
SB  - IM
MH  - Activities of Daily Living/classification/*psychology
MH  - Adult
MH  - *Community Mental Health Services
MH  - Comorbidity
MH  - Female
MH  - Follow-Up Studies
MH  - *Health Care Rationing
MH  - Humans
MH  - Male
MH  - Mental Disorders/classification/*diagnosis/rehabilitation
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Psychiatric Status Rating Scales/*statistics & numerical data
MH  - Rehabilitation, Vocational
MH  - Social Adjustment
MH  - Substance-Related Disorders/classification/*diagnosis/rehabilitation
MH  - United States
EDAT- 2002/06/05 10:00
MHDA- 2002/08/02 10:01
CRDT- 2002/06/05 10:00
PHST- 2002/06/05 10:00 [pubmed]
PHST- 2002/08/02 10:01 [medline]
PHST- 2002/06/05 10:00 [entrez]
AID - 10.1176/appi.ps.53.6.730 [doi]
PST - ppublish
SO  - Psychiatr Serv. 2002 Jun;53(6):730-7. doi: 10.1176/appi.ps.53.6.730.