Axis I

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Axis I is part of the DSM "multiaxial" system for assessment. The five axis model is designed to provide a comprehensive diagnosis that includes a complete picture of not just acute symptoms but of the entire scope of factors that account for a patient's mental health. This page explains DSM Axis I

Axis I: Clinical Disorders

This is the top-level of the DSM multiaxial system of diagnosis. It represents acute symptoms that need treatment; Axis I diagnoses are the most familiar and widely recognized (e.g., major depressive episode, schizophrenic episode, panic attack). Axis I terms are classified according to V-codes by the medical industry (primarily for billing and insurance purposes).

Clinical Disorders are grouped into categories listed below with examples of each.

Major Categories of DSM Clinical Disorders

Adjustment Disorders

  • With Anxiety
  • With Depressed Mood
  • With Disturbance of Conduct
  • With Mixed Anxiety and Depressed Mood
  • With Mixed Disturbance of Emotions and Conduct
  • Unspecified.

Anxiety Disorders

Cognitive Disorders (Delirium, Dementia, and Amnestic).

Dissociative Disorders.

  • Depersonalization Disorder
  • Dissociative Amnesia
  • Dissociative Fugue
  • Dissociative Identity Disorder
  • Dissociative Disorder Not Otherwise Specified (NOS)

Eating Disorders.

  • Anorexia Nervosa
  • Bulimia Nervosa
  • Eating Disorder Not Otherwise Specified (NOS)

Factitious Disorders.

  • With Combined Psychological and Physical Signs and Symptoms
  • With Predominantly Physical Signs and Symptoms
  • With Predominantly Psychological Signs and Symptoms

Impulse-Control Disorders (Not Classified Elsewhere).

  • Impulse-Control Disorder Not Otherwise Specified (NOS)
  • Intermittent Explosive Disorder
  • Kleptomania
  • Pathological Gambling
  • Pyromania
  • Trichotillomania

Mental Disorders Due to a General Medical Condition

  • Catatonic Disorder Due to a General Medical Condition
  • Personality Change Due to a General Medical Condition

Mood Disorders

Schizophrenia and other Psychotic Disorders

Sexual and Gender Identity Disorders.

Paraphilias:

  • Exhibitionism
  • Fetishism
  • Frotteurism
  • Pedophilia
  • Sexual Masochism
  • Sexual Sadism
  • Transvestic Fetishism
  • Voyeurism
  • Paraphilia Not otherwise Specified

Sexual Dysfunction:

  • Hypoactive Sexual Desire Disorder
  • Female Orgasmic Disorder (Inhibited Female Orgasm)
  • Female Sexual Arousal Disorder
  • Male Erectile Disorder
  • Male Orgasmic Disorder (Inhibited Male Orgasm)
  • Premature Ejaculation
  • Sexual Aversion Disorder
  • Sexual Dysfunction Due to a General Medical Condition
  • Substance-Induced Sexual Dysfunction
  • Sexual Dysfunction Not Otherwise Specified (NOS)

Sexual Pain Disorders:

  • Dyspareunia (Not Due to a General Medical Condition)
  • Vaginismus (Not Due to a General Medical Condition)

Sleep Disorders.

  • Breathing-Related Sleep Disorder
  • Circadian Rhythm Sleep Disorder
  • Dyssomnias Not Otherwise Specified. (NOS)
  • Insomnia Related to Another Mental Disorder
  • Nightmare Disorder (Dream Anxiety Disorder)
  • Primary Sleep Disorders:
    • Primary Insomnia
    • Primary Hypersomnia
    • Narcolepsy
  • Sleep Disorder Due to a General Medical Condition
  • Sleep Disorder Related to Another Mental Disorder
  • Sleep Terror Disorder
  • Sleepwalking Disorder
  • Substance-Induced Sleep Disorder

Somatoform Disorders.

  • Somatization Disorder
  • Undifferentiated Somatoform Disorder
  • Conversion Disorder
  • Pain Disorder
  • Hypochondriasis.Body Dysmorphic Disorder
  • Somatoform Disorder not Otherwise Specified (NOS)

Substance-Related Disorders.

Axis I in DSM-5

The next edition of the DSM is scheduled for publication in May, 2013. Working groups are reviewing the multiaxial system to try to bring it more into line with international reporting standards (as opposed to U.S. standards) with the goal of having a global approach to mental health diagnosis. Regarding Axis I, the American Psychiatric Association states,

The subgroup has recommended that DSM-5 collapse Axes I, II, and III into one axis that contains all psychiatric and general medical diagnoses. This change would bring DSM-5 into greater harmony with the single-axis approach used by the international community in the World Health Organization’s (WHO) International Classification of Diseases (ICD).

An example of a multiaxial diagnosis

From Edward Pierce, LCSW

  • Axis I: Major Depressive Disorder, Single Episode, Severe Without Psychotic Features
  • Axis II: Dependent Personality Disorder Frequent use of denial
  • Axis III: None
  • Axis IV: Threat of job loss
  • Axis V: GAF = 35 (last year)

Related Reading

Click below to read articles related to Axis I and the DSM.

 
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