The DSM is published by the American Psychiatric Association (APA).
The DSM has gone through many changes over the years.
A diagnosis under the fourth edition of this manual, the DSM-IV, had five parts calledAxes.
âVerywell / Nusha Ashjaee
Each Axis of this multi-axial system provided a different pop in of information about a diagnosis.
The Axes were introduced as a way for clinicians to record additional diagnostic information.
Axis I: Mental Health and Substance Use Disorders
Axis I provided information about clinical disorders.
Any mental health conditions, other thanpersonality disordersor intellectual development disorders, would have been included here.
This means that conditions listed under those categories were recategorized in the DSM-5.
Eating Disorders was renamed to Feeding and Eating Disorders.
In addition, Mood Disorders was broken out into two separate categories:Bipolarand Related Disorders and Depressive Disorders.
Sexual and Gender Identity Disorders was revised to Sexual Dysfunctions,Gender Dysphoria, and Paraphilic Disorders.
The DSM-5 changed this toIntellectual Disability.
Intellectual disability is still included in parentheses for continued use.
For instance, someone who has cancer and is undergoing chemotherapy may experience mental health issues likeanxietyanddepression.
Their cancer would be considered an Axis III condition because it is a health issue that influences mental health.
Any conditions that were previously categorized in Axis III are still documented as mental health concerns in the DSM-5.
Clinicians can simply make note of this in order of priority.
These notations can be added on to diagnoses as needed.
Many felt that the distinction was arbitrary between diagnoses in Axis I and Axis II.
There were concerns that some diagnoses didn’t fit “cleanly” into either category.
It also updated language to avoid confusion and address racial and cultural bias.
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Washington, DC; 2013.
American Psychiatric Association.Highlights of changes from DSM-IV-TR to DSM-5.
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DSM-5 changes: implications for child serious emotional disturbance.
American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders.5th ed, text revision.
Washington, D.C.; 2022.
Centers for Disease Control and Prevention.Common feelings after cancer treatment.
et al.The removal of the multiaxial system in theDSM-5: implications and practice suggestions for counselors.The Professional Counselor.
2014;4(3).
Substance Abuse and Mental Health Services Administration.
DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet].
Rockville (MD):Substance Abuse and Mental Health Services Administration (US); 2016 Jun.
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