The most widely used methods of impairment rating at the present time are the Guides to the Evaluation of Permanent Impairment issued by the American Medical Association, developed from a series of articles in the Journal of the American Medical Association during the period February 1958 to August 1970. This chapter will discuss concerns related to the evaluation of impairment associated with pain and with ‘mental and behavioral disorders’. However, before doing so the most important concerns related to the basic concepts and terminology used in this field of clinical medicine are discussed, namely the usage and meaning of terms such as “impairment”, “disability” and “handicap”. The chapter on the evaluation of impairment associated with “mental and behavioral disorders” in the 6th edition of the AMA Guides requires the use of three instruments, namely: (1) the Brief Psychiatric Rating Scale for the rating of symptoms; (2) the Global Assessment of Functioning Scale (GAF) from DSM-IV for the rating of ‘psychological, social, and occupational functioning’-it should be noted that the GAF has been “dropped from DSM-5 for among others, its conceptual lack of clarity and questionable psychometrics in routine practice”;-and (3) the mis-named Psychiatric Impairment Rating Scale, which incorrectly includes “Travel” and ‘Employability’ as ratings of psychiatric impairment. The chapter will provide an overview of the Guide to the Evaluation of Psychiatric Impairment for Clinicians (GEPIC), developed in Victoria, Australia, which in our view is the only currently published instrument that rates psychiatric impairment without allowing the rating to be contaminated by what the WHO would consider as aspects of disability and/or handicap using the definitions set out in the ICIDH.
|Title of host publication||P5 Medicine and Justice|
|Subtitle of host publication||Innovation, Unitariness and Evidence|
|Editors||Santo Davide Ferrara|
|Place of Publication||Cham, Switzerland|
|Number of pages||34|
|Publication status||Published - 1 Jan 2018|