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Multi-axial classification 

Multi-axial classification
Multi-axial classification

John E. Cooper

and Norman Sartorius

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date: 21 November 2018

The idea that it would be useful to systematically record key elements describing the condition of mentally ill people on several axis (e.g. that of disability) was introduced early in the 20th century by Kretschmer who recommended that psychiatrists should note the causal factors in addition to the diagnosis for each of their patient. Other proposals followed suggesting the systematic recording of matters such as personality traits or disorders, severity of disability produced by the psychiatric disorder, the environmental factors influencing the onset and development of the disorders and the legal implications of the disorder. The most widely known scheme is the one included in the fourth revision of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM- IV). The most recent proposal for a multi-axial classification (using six axes) is that produced by the World Health Organization for use in child psychiatry. While there is general agreement that it would be useful to accompany the diagnosis by recording on several other axes some key features of the patient’s state, in practice the systematic and consistent use of multi-axial classifications as a routine part of psychiatric record keeping in case-notes used for clinical care is probably not widespread.

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