Global Assessment of Functioning (GAF) Scale
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Consider psychological, social, and occupational functioning on a hypothetical continuum ofnientallie~l_th­
illness. Do not include impairment in functioning due to physical (or environmental) limitations.
(Note: When using the GAF scale, rate .by using any numeral from 0 to 100 that reflects the individual'$ _- ·
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overall level of functioning)
Code
Code
100
1
91
Superior functioning in a wide range of activities, life's
problems never seem to get out of hand, is sought out
by others because of his or her many positive
qualities. No symptoms.
50
I
41
Serious symptoms (e.g., suicidal ideation, severe obsessional
rituals, frequent shoplifting) OR any serious impairment in social,
occupational, or .school functioning (e.g., no friends, unable
to keep job).
90
1
81
Absent or minimal symptoms (e.g., mild anxiety before
an exam), good functioning in all areas, interested
and involved in a wide range of activities, socially
effective, generally satisfied with life, no more than
everyday problems or concerns (e.g., an occasional
argument with family members).
Some impairment in reality testing or communication (e.g.,
speech is at times illogical, obscure, or irrelevant) OR major
impairment in several areas, such as work or school, family
relations, judgement, thinking, or mood (e.g., depressed man
avoids friends, neglects family, and is unable to work; child frequently
beats up younger children, is defiant at home, and is failing at school).
80
1
71
If symptoms are present, they are transient and
expectable reactions to psychosocial stressors (e.g.,
difficulty concentrating after family argument) no more
than slight impairment in social, occupational, or
school functioning (e.g., temporarily falling behind in
schoolwork).
Behaviour is considerably influenced by delusions or
hallucinations OR serious impairment in communication or
judgement (e.g. sometimes incoherent, acts grossly inappropriately,
suicidal preoccupation) OR inability to function in almost all areas
(e.g., stays in bed all day; no job, home, or friends).
70
1
61
Some mild symptoms (e.g., depressed mood and mild
insomnia) OR some difficulty in social, occupational,
or school functioning (e.g., occasional truancy, or theft
within the household}, but generally functioning pretty
well, has some meaningful interpersonal relationships.
60
1
Moderate symptoms (e.g., flat affect and circumstantial
' speech, occasional panic attacks) OR moderate difficulty
i in social, occupational, or school functioning (e.g ., few
friends, conflicts with peers or co-workers).
51
Some danger of hurting self or others (e.g., suicide attempts
without clear expectation of death; frequently violent; manic
excitement) OR occasionally fails to maintain minimal personal
hygiene (e.g., smears feces) OR gross impairment in
communication (e.g., largely incoherent or mute).
Persistent danger of severely hurting self or others (e.g., recurrent
violence) OR persistent inability to maintain minimal personal
hygiene OR serious suicidal act with clear expectation of death.
Inadequate information.
DSM-IV Multiaxial System
• Disorders usually first diagnosed in infancy, childhood, or
adolescence (excluding mental retardation , which is
diagnosed on Axis II)
• Delirium, dementia and amnestic and other cognitive disorders
• Mental disorders due to a general medical condition
• Substance-related disorders
• Schizophrenia and other psychotic disorders
• Mood disorders
• Anxiety disorders
• Somatoform disorders
• Factitious disorders
• Dissociative disorders
• Sexual and gender identity disorders
• Eating disorders
• Sleep disorders
• Impulse-control disorders not elsewhere classified
• Adjustment disorders
Axis II
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t ·;
• Infectious and parasitic diseases
• Neoplasms
• Endocrine, nutritional and metabolic diseases
and immunity disorders
• Diseases of the blood and blood-forming organs
• Diseases of the nervous system sense organs
• Diseases of the circulatory system
• Diseases of the respiratory system
• Diseases of the digestive system
• Diseases of the genitourinary system
• Complications of pregnancy, childbirth and the puerperium
• Diseases of the skin and subcutaneous tissue
• Diseases of the musculoskeletal system and
connective tissue
• Congenital anomalies
• Certain conditions originating in the perinatal period
• Symptoms, signs, and ill-defined conditions
• Injury and poisoning
Axis IV
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Axis V is for reporting the clinician's judgment of the
individual's overall level of functioning. This information
is useful in planning treatment and measuring its impact
and in predicting outcome.
The reporting of overall functioning on Axis V can be done
using the Global Assessment of Functioning (GAF) Scale.
The GAF Scale can be particularly useful in tracking the
clinical progress of individuals in global terms, using a
single measure. The GAF Scale is to be rated with respect
only to psychosocial, social, and occupational functioning.
The instructions specify, "Do not include impairment in
functioning due to physical (or environmental) limitations."
In most instances, ratings on the GAF Scale should be for
the current period (i.e., the level of functioning at the time
of the evaluation) because ratings of current functioning
will generally reflect the need for treatment or care. In
• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder
• Antisocial personality disorder
• Borderline personality disorder
• Histrionic personality disorder
• Narcissistic personality disorder
• Avoidant personality disorder
• Dependent personality disorder
• Obsessive compulsive personality disorder
• Personality disorder not otherwise specified
• Mental retardation
some settings, it may be useful to note the GAF Scale
• Problems with primary support group
• Problems related to the social environment
• Educational problems
• Occupational problems
• Housing problems
• Economic problems
• Problems with access to health care services
• Problems related to interaction with the legal system/crime
• Other psychosocial and environmental problems
rating both at time of admission and at time of discharge.
The GAF scale may also be rated for other time periods
(e.g. , the highest level of functioning for at least a few
months during the past year). The GAF Scale is reported
on Axis V as follows: "GAF= ," followed by the GAF rating
from 0 to 100, followed by the time period reflected by the
rating in parentheses- for example "(current)': "(highest
level in past year)", "(at discharge)".