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Axis I
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
- Acute Stress Disorder
- Agoraphobia
- Agoraphobia Without History of Panic Disorder
- Anxiety Disorder Due to a General Medical Condition
- Anxiety Disorder Not Otherwise Specified (Anxiety Disorder NOS)
- Generalized Anxiety Disorder (GAD)
- Obsessive-Compulsive Disorder (OCD)
- Panic Attack
- Panic Disorder With Agoraphobia
- Panic Disorder Without Agoraphobia
- Posttraumatic Stress Disorder
- Social Phobia
- Specific Phobia
- Substance-Induced Anxiety Disorder
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
- Bipolar I Disorder
- Bipolar II Disorder
- Bipolar Disorder Not Otherwise Specified (NOS)
- Cyclothymic Disorder
- Depressive Disorder Not Otherwise Specified (NOS)
- Depression (General Overview)
- Dysthymic Disorder
- Major Depressive Disorder
- Mood Disorder Due to a General Medical Condition
- Mood Disorder Not Otherwise Specified (NOS)
- Substance-Induced Mood Disorder
Schizophrenia and other Psychotic Disorders
- Paranoid Type
- Disorganized Type
- Catatonic Type
- Undifferentiated Type
- Residual Type
- Brief Psychotic Disorder
- Delusional Disorder
- Psychotic Disorder Due to a General Medical Condition
- Psychotic Disorder Not Otherwise Specified
- Schizoeffective Disorder
- Schizophreniform Disorder
- Substance-Induced Psychotic Disorder
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.
- Substance-Induced Anxiety Disorder.
- Substance-Induced Mood Disorder.
- Substance-Induced Psychotic Disorder.
- Substance-Induced Sleep Disorder.
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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