![]() Many of these general changes from Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) to DSM-5 are summarized in the report Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. Elimination of the Multi-Axial System and GAF Score This report will supplement that information by providing details specifically about changes to disorders of childhood and their implications for generating estimates of child serious emotional disturbance (SED).Ģ.1. One of the key changes from DSM-IV to DSM-5 is the elimination of the multi-axial system. DSM-IV approached psychiatric assessment and organization of biopsychosocial information using a multi-axial formulation ( American Psychiatric Association, 2013b). Axis I consisted of mental health and substance use disorders (SUDs) Axis II was reserved for personality disorders and mental retardation Axis III was used for coding general medical conditions Axis IV was to note psychosocial and environmental problems (e.g., housing, employment) and Axis V was an assessment of overall functioning known as the GAF. The GAF scale was dropped from the DSM-5 because of its conceptual lack of clarity (i.e., including symptoms, suicide risk, and disabilities in the descriptors) and questionable psychometric properties ( American Psychiatric Association, 2013b).Īlthough the impact of removing the overall multi-axial structure in DSM-5 is unknown, there is concern among clinicians that eliminating the structured approach for gathering and organizing clinical assessment data will hinder clinical practice ( Frances, 2010). ![]() However, the direct impact on the prevalence rates of childhood mental disorders is likely to be negligible as it will not affect the characteristics of diagnoses.ĭSM-IV and DSM-5 categorize disorders into “classes” with the intent of grouping similar disorders (particularly those that are suspected to share etiological mechanisms or have similar symptoms) to help clinician and researchers use of the manual. From DSM-IV to DSM-5, there has been a reclassification of many disorders that reflects a better understanding of the classifications of disorders from emerging research or clinical knowledge. Table 3 lists the disorder classes included in DSM-IV and DSM-5. In DSM-5, six classes were added and four were removed. ![]() As a result of these changes in the overall classification system, numerous individual disorders were reclassified from one class to another (e.g., from “mood disorders” to “bipolar and related disorders” or “depressive disorders”).
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