DSMIV American Psychiatric Association 1994

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) comprises the official classification system of the American Psychiatric Association, and has been influential in the UK. DSM-IV is a multiaxial system with five axes:

Axis I: Clinical syndromes

Axis II: Developmental disorders and personality disorders

Axis III: Physical disorders and conditions

Axis IV: Severity of psychosocial stressors

Axis V: Global assessment of functioning.

The strength of this approach lies in its requiring any clinical syndrome to be considered against the background of the permanent features, such as personality characteristics and intellectual level, of the person concerned. Each syndrome is defined by a set of practical criteria.

Comparison of DSM and ICD

Symptoms must be 'more than an understandable reaction' for diagnosis Mental health only Subscription only

Guides only - need expert interpretation

WHO, including UK No such test explicit

All of medicine Free online

Consensus statements of committees - not immutable truths

The chapter headings in this book do not follow either ICD-10 or DSM-IV exactly, because the arrangement of topics has been designed to accord with UK clinical practice rather than official classification systems.

Further reading

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders

(4th edn) (DSM-IV). Washington, DC: American Psychiatric Association. World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO. http://www3.who.int/icd/currentversion/fr-icd.htm.

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