DSM IV

In use from 1994 to 2014, the longest used version of DSM. It's phasing out way delayed by debate over the proper re-organization of DSM-5 which had been hotly contested by Medical Insurance and Majot Pharmeceutical corporations wanting to have an influence on its development.

Multi-axial system of classification that makes use of clinical symptoms and personality disorders on the first two axes. Medical conditions on axis III. Psychosocial and environmental problems (Stressors) are also considered on axis IV while a global assessment of functioning is made on axis V.

Axis I General Disorders

1. Infancy, childhood, adolescent onset
(e.g., ADD, Autistic Disorder, enurisis, mental retardation)

2. Organic mental disorders
(e.g., delirium, dementia, amnesia)

3. Substance related disorders (maladaptive)
(e.g., alcohol, cocaine, prozac, ...)

4. Schizophrenia & psychotic disorders
(over 6 months or longer + lesser forms)

5. Mood disorders - emotional disturbance

6. Anxiety disorders - tension, heart palpitations & fear - continuous or diffuse

7. Somatoform disorders - psychological cause

8. Dissociative disorders - memory, identity & consciousness

9. Sexual and gender-identity disorders - focus on discomfort, paraphilias & dysfunction

We will look closely at the following:

A) Anxiety Disorders - excessive apprehension and anxiety or fear

B) Somatoform Disorders

D) Mood Disorders (tend to be episodic)

E) Schizophrenic Disorders

Axis II Personality Disorders: Rigid and inflexible personality types

A) Anxious/Fearful 

B) Odd/ Eccentric

C) Dramatic/ Impulsive

 

Axis III General Medical Conditions

Any medical condition that might be important to note: diabetes, arthritis, hypertension, haemophilia,… (treated?)

Axis IV Psychosocial and Environmental Problems

Any external conditions that may affect diagnosis on axis I or II. E.g., environmental challenges, interpersonal distress, lack of social support, …

Axis V Global Assessment of functioning

A numerical code that estimates the level of functioning ranging from 1 - 100.

100 = superior functioning in a wide variety of faculties

90 = minimal symptoms & good function in all areas

80 = transient symptoms & expectable reactions to stress

70 = mild symptoms or social/occupational dysfunction, but generally doing well

60 = moderate symptoms & difficulties in school/work/social

50 = serious symptoms

40 = impaired reality testing

30 = delusional or serious impairment

20 = Some danger in hurting self or others, gross communication deficits

10 = persistent danger to self or others !