Student Nurse Laura

Orem – "creative effort of one human being to help another human being."


Posted by Laura on July 21, 2010

Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision.

“Standard nomenclature of emotional illness published by the American Psychiatric Association (APA) and used by all health care practitioners. It classifies mental illness and presents guidelines and diagnostic criteria for various mental disorders.”   Psychiatric Mental Health Nursing, 6th edition, Townsend

Published in July 2000 as a update to be official in 2014. The last updated DSM-IV was in 1994.

This is the original DSM-I

My diagram of the Diagnostic and Statistical Manual shows the 5 Multi-axial system.

There are 3 Components of the DSM:

Diagnostic Classification – list of the mental disorders
Diagnostic Criteria –  description of each disorder
Descriptive Text accompanies each disorder with descriptions under the following headings: Diagnostic Features *  Subtypes and/or Specifiers * Recording Procedures * Associated Features and Disorders * Specific Culture, Age, and Gender Features * Prevalence * Course * Familial Pattern * Differential Diagnosis

Multi-axial system

The DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability:

  • Axis I: Clinical disorders, including major mental disorders, and learning disorders. Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, phobias, and schizophrenia.
  • Axis II: Personality disorders and mental retardation. Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.
  • Axis III: Acute medical conditions and physical disorders. Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.
  • Axis IV: Psychosocial and environmental factors contributing to the disorder.
  • Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18

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