A Comparison of Psychiatrists' Clinical-Impression-Based and Social Workers' Computer-Generated GAF Scores

The authors studied the utility of the DSM-IV Global Assessment of Functioning (GAF) scale for improving interdisciplinary communication about patient care. Discharge GAF scores for 165 discharged inpatients were computer generated by 13 trained unit social workers and derived by eight psychiatrists on the basis of their clinical impressions. Differences between the scores obtained by the two disciplinary groups were tested by using the paired t test and the nonparametric signed-rank test. Agreement between scores for various GAF categories was tested with kappa agreement indexes. Interdisciplinary agreement on discharge GAF scores was observed across diagnostic categories and across most categories of length of stay. The results suggest that social workers, after receiving systematic training in computer-based GAF reports, can provide reasonable assessments of clients' functioning.