GAF Scores for Bipolar Disorder Patients

Global Assessment of Functioning, or GAF for short, is a tool used by mental health professionals to rate three areas--social, psychological and occupational--of an adult's life in order to determine her ability to function. The GAF scores, used for bipolar disorder assessment and other mental health disorders as well, are broken down into ten categories, which are numbered 1 to 10, 11 to 20, and so on. The highest score possible, 91 to 100 (the tenth category), is assigned to individuals functioning extremely well, and the lowest score (1 to 10) is reserved for those who are suicidal or a danger to others.

GAF and the Diagnostic and Statistical Manual for Mood Disorders (DSM-IV-TR)

In the Diagnostic and Statistical Manual for Mood Disorders, also known as the DSM, there exist several categories for bipolar disorder. These categories, called "axis" in the DSM, serve to break down the bipolar disorder per severity and symptom, making it easier for mental health professionals to diagnose and prescribe treatments for the disorder based on the patients' behaviors and symptoms.

One critical tool most often used in this diagnosis process is the Global Assessment of Functioning scoring system (GAF). Using a numerical scale from 1 to 100 and ten categories that closely mirror the DSM in symptom descriptions of bipolar disorder, GAF seeks to aid clinicians in accurately measuring functioning levels of those who have bipolar disorder.

In addition, since GAF is broken down into ten categories, and the DSM's categories (or axes) are less than half that in number, GAF is able to afford clinicians some leeway when diagnosing bipolar disorder, since not every individual will fit nicely into one of the DSM axis categories.

91-100 GAF score

In most scoring systems, the higher the score assessed the better. The same is true with the GAF scores for bipolar disorder. When diagnosing bipolar disorder, a GAF score of 91 to 100 is indicative of an individual who is functioning quite well in society on many levels and whose company is sought by other individuals. This person is not displaying any bipolar disorder symptoms.

71-90 GAF score

In both the 71 to 80 and the 81 and 90 GAF scores, the bipolar individual appears to be functioning successfully in society on the whole, just not functioning as highly as those who scored 91 to 100 with the GAF tool.

While these two lower category scores reflect that the individual may have no obvious symptoms, they also reflect that any symptoms that are experienced in these categories will be minimal and easily attributed to everyday situations or problems that we all face from time to time.

Those who fall into these two categories generally are active in daily activities and enjoy the interactions with others quite successfully.

51-70 GAF score

The 51 to 60 and the 61 to 70 scores show that mild to moderate symptoms are now present with the individual, and some difficulties are occurring in regards to functioning in school, social or occupational capacities.

The individual experiencing these scores might be having problems successfully interacting with others due to mood swings or an inability to "do their job" because of periods of depression. They are still successfully functioning to some degree most of the time but probably need medical assistance and intervention for any depression symptoms. In addition, clinicians may attempt to provide talk therapy about conflict resolution as well.

31-50 GAF score

These two category scores (31 to 40 and 41 to 50), reflect that the individual being analyzed has reached a point where more treatment is not only recommended; it is necessary. This individual has reached a point where there has been some reality issues surface that necessitates probable medication intervention, as well as a serious move towards being unable to perform daily activities in the work place or home on a successful and continuous basis.

They are not incapacitated at this scoring phase or considered a danger to themselves or others, but they are sliding in that direction without proper diagnosis and treatment.

11-30 GAF score

The 21 to 30 GAF score reflects individuals who are not just having some reality issues; they have actually begun to have hallucinations or delusions, or they are experiencing some major impairment in the areas of judgment or communication. Hence, their relationships with others are most likely at an extreme low at this point, if not suffering from an absence altogether.

Individuals who are assessed the 11 to 20 score will likely exhibit a neglect of personal hygiene, and their lack of bathing and appearance concerns will be quite obvious. In addition, they present a possible danger to themselves and others at this particular stage in the scoring process.

1-10 GAF score

This is the most dangerous score clinicians can reach when using GAF because it represents individuals who have bipolar disorder and are most likely to hurt themselves or others and who are fully expectant of achieving death upon any act of suicide attempted.

Hygiene is no longer a concern at all by individuals who are given this score, as they are most likely not able to maintain any attempt at hygiene anyway due to their deteriorating mental condition.

Those receiving this GAF score need hospitalization and/or immediate medical treatment in order to protect them and society.