Global Function Scales

  • Michael Phelan
  • Til Wykes
  • Howard Goldman


There is a close relationship between impairment of global functioning and mental illness. However valid measurement of global functioning is difficult, and there is no perfect scale. The instruments reviewed in this paper illustrate a range of different approaches. Despite the inherent difficulties the measurement of functioning is a critical domain in mental health evaluative research.


Interrater Reliability Global Functioning Instrumental Behaviour Axis Versus Social Maladjustment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Affleck JW, McGuire RJ (1984) The measurement of psychiatric rehabilitation status: a review of the needs and a new scale. Br J Psychiatry 145: 517–525PubMedCrossRefGoogle Scholar
  2. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn revised. American Psychiatric Association, Washington, DCGoogle Scholar
  3. Baker R, Hall JN (1983) Rehabilitation evaluation of Hall and Baker (REHAB). Vine Publishing Ltd, Aberdeen, ScotlandGoogle Scholar
  4. Baker R, Hall JN (1988) REHAB: a new assessment instrument for chronic psychiatric patients. Schizophr Bull 14: 95–113Google Scholar
  5. Ciarlo JA, Riehman J (1977) The Denver Community Mental Health Questionnaire: development of a multidimensional program evaluation. In: Coursey RD, Specter GA, Murrell SA, Hunt B (eds) Program evaluation for mental health: methods, strategies and participants. Grune & Stratton, New YorkGoogle Scholar
  6. Clare AW, Cairns VE (1978) Design, development and use of a standardized interview to assess social maladjustment and dysfunction in community studies. Psychol Med 8: 589–604PubMedCrossRefGoogle Scholar
  7. Clark A, Fiedman MJ (1983) Nine standardized scales for evaluating treatment outcomes in a mental health cHnic. J Clin Psychol 39: 939–950PubMedCrossRefGoogle Scholar
  8. Dohrenwend BS, Cook D, Dohrenwend BP (1981) Measurement of social functioning in community populations. In: Wing JK, Bebbington P, Robbins L (eds) What is a case? Grant Mclntyre, LondonGoogle Scholar
  9. Dworkin RJ, Friedman LC, Telschow RL, Grant KD, Moffic HS, Sloan VJ (1990) The longitudinal use of the Global Assessment Scale in multiple-rater situations. Community Ment Health J 26: 335–344PubMedCrossRefGoogle Scholar
  10. Endicott J, Spitzer RL (1972 a) What another rating scale? The Psychiatric Evaluation Form. J Nerv Ment Disord 154: 88–104Google Scholar
  11. Endicott J, Spitzer RL (1972b) Current and Past Psychopathology Scales (CAPPS): rationale, reHability, and validity. Arch Gen Psychiatry 27: 678–687PubMedCrossRefGoogle Scholar
  12. Endicott J, Spitzer RL, Fleiss JL, Cohen J (1976) The Global Assessment Scale. Arch Gen Psychiatry 33: 766–771PubMedCrossRefGoogle Scholar
  13. Fernando T, Mellsop G, Nelson K, Peace K, Wilson J (1986) The rehability of axis V of DSM-III. Am J Psychiatry 143: 752–755PubMedGoogle Scholar
  14. Goldman HH, Skodol AE, Lave TR (1992) Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 149:1148–1156PubMedGoogle Scholar
  15. Hogarty GE, Katz MM (1971) Norms of adjustment and social behaviour. Arch Gen Psychiatry 25: 470–480PubMedCrossRefGoogle Scholar
  16. Hurry J, Sturt E (1981) Social performance in a population sample: relation to psychiatric symptoms. In Wing JK, Bebbington P, Robbins L (eds) What is a case? Grant Mclntyre, LondonGoogle Scholar
  17. Kane RA, Kane RL, Arnold S (1985) Measuring social functioning in mental health studies: concepts and instruments. Mental Health Service System Reports, Series DN No. 5 NIMHGoogle Scholar
  18. Katz MM, Lyerly SB (1963) Methods for measuring adjustment and social behaviour in the community: 1. rationale, description, discriminative vaHdity and scale development. Psychol Rep 13: 503–535CrossRefGoogle Scholar
  19. Luborsky L (1962) Clinicians judgements of mental health. A proposed scale. Arch Gen Psychiatry 7: 407–417PubMedCrossRefGoogle Scholar
  20. Luborsky L, Bachrach H (1974) Factors influencing clinician’s judgements of mental health. Arch Gen Psychiatry 31: 292–299PubMedCrossRefGoogle Scholar
  21. Mezzich JE, Fabrega H Jr, Coffman GA (1987) Multiaxial characterization of depressive patients. J Nerv Ment Disord 175: 339–346CrossRefGoogle Scholar
  22. Paykel ES (1972) Correlates of a depressive typology. Arch Gen Psychiatry 27: 203–210PubMedCrossRefGoogle Scholar
  23. Plakun EM, Muller JP, Burkhardt PE (1987) The significance of borderUne and schizotypal overlap. Hillside J Clin Psychiatry 9: 47–54PubMedGoogle Scholar
  24. Remington M, Tyrer P (1979) The social functioning schedule — a brief semistructured interview. Soc Psychiatry 14:151–157CrossRefGoogle Scholar
  25. Rey JM, Plapp JM, Stewart GW, Richards IN, Bashir MR (1987) Reliability of the psychosocial axes of DSM-III in an adolescent population. Br J Psychiatry 150: 228–234PubMedCrossRefGoogle Scholar
  26. Rey JM, Stewart GW, Plapp JM, Bashir MR, Richards IN (1988) Validity of axis V of DSM-III and other measures of adaptive functioning. Acta Psychiatr Scand 77: 534–542CrossRefGoogle Scholar
  27. Rosen A, Hadzi-Pavlovic D, Parker G (1989) The Life Skills Profile: a measure assessing function and disability in schizophrenia. Schizophr Bull 15: 325–337PubMedGoogle Scholar
  28. Schräder G, Gordon M, Harcourt R (1986) The usefulness of DSM-III axis IV and V assessments. Am J Psychiatry 143: 904–907PubMedGoogle Scholar
  29. Schubert C, Krumm B, Biehl H, Schwarz R (1986) Measurement of social disability in a schizophrenic patient group: definition, assessment and outcome over two years in a cohort of schizophrenic patients of recent onset. Soc Psychiatry 21: 1–9CrossRefGoogle Scholar
  30. Skodol AE, Link BG, Shrout PE, Horwath E (1988) Toward construct validity for DSM III axis V Psychiatry Res 24:13–23PubMedCrossRefGoogle Scholar
  31. Spitzer RL, Forman JBW (1979) DSM-III field trials, II: initial experience with the multiaxial system. Am J Psychiatry 136: 818–820PubMedGoogle Scholar
  32. Spitzer RL, Endicott J, Fleiss JL, Cohen J (1970) The Psychiatric Status Schedule: a technique for evaluating psychopathology and impairment in role ftmctioning. Arch Gen Psychiatry 23: 41–55PubMedCrossRefGoogle Scholar
  33. Wallace CJ (1986) Functional assessment in rehabilitation. Schizophr Bull 12: 604–624PubMedGoogle Scholar
  34. Weissman MM, Sholomskas D, John K (1981) The assessment of social adjustment: an update. Arch Gen Psychiatry 38:1250–1258PubMedCrossRefGoogle Scholar
  35. Westermeyer J (1988) DSM-III psychiatric disorders among Hmong refugees in the United States: a point prevalence study. Am J Psychiatry 145: 197–202PubMedGoogle Scholar
  36. Westermeyer J, Neider J (1988) Social networks and psychopathology among substance abusers. Am J Psychiatry 145:1265–1269Google Scholar
  37. World Health Organisation (1988) WHO Psychiatric Disabihty Assessment Scale (WHO/DAS). WHO, GenevaGoogle Scholar
  38. Wykes T, Sturt E (1986) The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. Br J Psychiatry 148:1–11PubMedCrossRefGoogle Scholar
  39. Wykes T (1992) The assessment of severely disabled psychiatric patients for rehabilitation. In: Kavanagh D (ed) Schizophrenia: an overview and practical handbook. Chapman Hall, LondonGoogle Scholar
  40. Wykes T, Hurry J (1991) Social behaviour and psychiatric disorder. In: Bebbington P (ed) Social psychiatry: theory, methodology and practice. Transactional Publishers, New BrunswickGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • Michael Phelan
    • 1
  • Til Wykes
    • 1
  • Howard Goldman
    • 2
  1. 1.Institute of PsychiatryPRiSMLondonUK
  2. 2.Department of Psychiatry, School of MedicineUniversity of MarylandBaltimoreUSA

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