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Multiaxial Diagnostic System of the DSM-IV-TR

The Five Axes

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Updated July 16, 2014

The DSM-IV-TR uses a five level diagnostic system to classify illnesses and disorders. When considered together, these 5 levels give the treatment provider a complete diagnosis that includes factors influencing your psychiatric condition. This is important for effective treatment planning.

The five levels of the DSM are called “axes” and are defined as follows:

Axis I is reserved for clinical disorders and developmental and learning disorders. Disorders that may be present on Axis I include:

Axis II is for personality disorders or mental retardation. Disorders that may appear on Axis II include:

Axis III is for medical and/or physical conditions or disorders. For example:

Axis IV indicates factors contributing to, or affecting, the current psychiatric disorder and treatment outcomes. These include:

  • Lack of an adequate support system
  • Social issues
  • Educational problems
  • Problems with work
  • Financial difficulties
  • Legal problems
  • Other psychosocial and environmental problems

Axis V is for the GAF or global assessment functioning. This is a 100-point scale that the mental health professional uses to describe the patient’s overall level of performance in usual daily activities and social, occupational, academic and interpersonal functioning.

Source:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.

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