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Acta Psychiatr Scand. 2007 Apr;115(4):326-30.

Are GAF scores reliable in routine clinical use?

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  • 1Department of Acute Psychiatry, UllevĂ„l University Hospital, Oslo, Norway.



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.


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.


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).


Inter-rater reliability of GAF scores in a routine clinical context seems to be insufficient.

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