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Global Functioning and Mental Health Parameters: Examining Interplay and Improvements in Inpatient Psychiatry
Alexander Finner1, Melanie Lenger1, Nina Dalkner1
1Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
Introduction:
Global functioning is a common clinician-rated measure of treatment changes in inpatient psychiatric care, but its broad scope may limit its sensitivity to specific mental health changes. This study aimed to research interplay and improvements of global functioning and several mental health parameters.
Methods:
At admission and discharge 561 inpatients at a psychiatric clinic received assessments for global functioning, depression severity (clinician- and self-rated), sleep quality, quality of life, life satisfaction, and mood level. ANCOVAs assessed mean changes, while multiple linear regressions explored predictors of global functioning at both time points and over time.
Results:
Global functioning and most mental health parameters significantly improved (p < 0.001-0.019, partial η2 = 0.02-0.14), except for sleep quality. Clinician-rated depression severity was consistently the strongest predictor of global functioning at admission, discharge, and over time (β = -0.56 to -0.47, p < 0.001). At admission, life satisfaction predicted global functioning improvement (β = 0.27, p = 0.038), while lower sleep quality indicated higher global functioning (β = 0.16, p = 0.041).
Conclusion:
The strong association between clinician-rated measures suggests a halo effect. A diagnostic and visualized integration of clinician- and self-rated measures is proposed for more reliability.
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