The DSM-IV, is a manual published by the American Psychiatric Association and is the number one resource (often referred to as the “bible” of psychology) that mental health professionals turn to when determining diagnoses of various mental disorders. This book systematically categorizes all of the diagnosable mental disorders (for both adults and children) as well as describing the etiology (causes) and differential diagnoses of the various illnesses. As a resource, this publication also references statistics for each disorder relating to gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches. The DSM-IV uses a multiaxial or multidimensional approach to diagnosing because, typically, other factors in a person's life will impact their mental health. It assesses mental health based on five dimensions (or Axis). Axis I: Clinical Disorders (this typically is the “diagnosis” such as schizophrenia) Axis II: Personality Disorders and/or Mental Retardation Axis III: General Medical Conditions (ICD-9 Codes should be present) Axis IV: Psychosocial and Environmental Problems (these would be vents in a persons life, such as death of a loved one, starting a new job, college, unemployment, and marriage which can impact the disorders listed in Axis I and II) Axis V: Global Assessment of Functioning (this is a score determined by the mental health professional the person's level of functioning both at the present time and the highest level within the previous year. This helps the mental health professional to understand how the above four axes are affecting the person and what type of changes could be expected) The DSM has gone through five revisions since it was first published as it tries to keep up with societal trends in mental health. This manual is unique in the fact that it is atheoretical. The DSM was originally created to allow for more objective terms for psychiatric research. By establishing specific criteria, mental health research has been greatly facilitated. Furthermore, the multiaxial system provides for a more complete picture of the patient, rather than just a simple diagnosis. The DSM-IV does caution against untrained people using it to make diagnosis as it was designed to be used by mental health professionals with clinical training. The disorders are listed under various categories. Diagnosis can then be further delineated with “specifiers”, such as mild or moderate, late or early onset, etc.
All of the Axis I diagnoses fall under one of the following clusters: Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence; Delirium, Dementia, and Amnestic and Other Cognitive Disorders; Mental Disorders Due to a General Medical Condition; Substance-Related Disorders; Schizophrenia and Other Psychotic Disorders; Mood Disorders; Anxiety Disorders; Somatoform Disorders; Factitious Disorders; Dissociative Disorders; Sexual and Gender Identity Disorders; Eating Disorders; Sleep Disorders; Impulse-Control Disorders Not Elsewhere Classified; and Adjustment Disorders. Axis II Disorders (with the exception of mental retardation) will all fall under the category of Personality Disorders (which is considered to be an enduring and inflexible pattern of inner experiences and behavior that differs significantly from one’s societal expectations). Additional categories include Relational Problems. Abuse/Neglect Problems, or Other Conditions That May Be a Focus of Clinical Attention, which are also known a “V Codes”. V-Code issues tend to be problems that may complicate or exacerbate the management of a mental disorder. When interpreting the DSM-IV, it is also important to realize that each diagnosis has a corresponding numerical code. The code can reflect the specific nature of the disorder as well as be used interchangeably with the diagnosis. For example, a mental health professional can refer to the client as being diagnosed with Major Depressive Disorder, Recurrent, Md (296Major Depressive Disorder, Recurrent, Moderate (296.22). In addition to these codes, the DSM-IV also includes ICD-9-CM which are the official coding system for general medical conditions and medication-induced disorders. Finally, the DSM-IV contains information on ICD-10 codes developed from the International Statistical Classification of Diseases and Related Health Problems. These codes are also compatible with the codes in the DSM-IV.