Gender differences in living skills and global assessment of functioning among outpatients with schizophrenia

Objective: The aims of this paper are to study skills in personal and domes tic activities, and their associations with Global Assessment of Functionin g (GAF) scale scores among outpatients with schizophrenia, and to study the impact of depressive mood on functional capacity in schizophrenia. Method: Three hundred and two outpatients with DSM-III-R schizophrenia comp leted the 13-item Beck Depression Inventory (BDI) and a questionnaire relat ing to their sociodemographic characteristics, and living and working condi tions. Staff members completed the GAF scale and a questionnaire relating t o the patient's medical history and current treatment. This questionnaire a lso included the staff's assessments on patient's skills in six personal or domestic activities (personal hygiene, homemaking, management of financial affairs, shopping, decision-making, getting about). Results: Fifty-six percent of men and 33% of women (p < 0.001) with schizop hrenia did not have independent skills in at least one personal or domestic activity but there was no difference in the mean GAF score between men and women. In men, the GAF score was independently and positively associated w ith all living skills studied and in women with homemaking, management of f inancial affairs, and decisionmaking, respectively. The BDI scores were not independently associated with functioning in personal and domestic activit ies except with getting about in women. Conclusions: The GAF scale is a simple and time-saving measure for assessin g overall living skills among outpatients with schizophrenia. However, asse ssments on the GAF scale may be biased towards poor functioning in women. M oreover, psychosocial functioning and depression should be evaluated separa tely.