DSM Levels of Functioning

This multiaxial approach was intended to help clinicians and psychiatrists make comprehensive evaluations of a client’s level of functioning because mental illnesses often impact many different life areas.

• Axis I: Clinical Syndromes
  This axis described clinical symptoms that cause significant impairment. Disorders were grouped into different categories such as mood disorders, anxiety disorders or eating disorders.

• Axis II: Personality and Mental Retardation
  This axis described long-term problems in functioning that were not considered discrete Axis I disorders.Personality disorders cause significant problems in how a patient relates to the world and include antisocial personality disorder and histrionic personality disorder. Mental retardation is characterized by intellectual impairment and deficits in other areas such as self-care and interpersonal skills.

• Axis III: Medical Conditions
  These included physical and medical conditions that influence or worsen Axis 1 and Axis II disorders. Some examples include HIV/AIDS and brain injuries.

• Axis IV: Psychosocial and Environmental Problems
  Any social or environmental problems that may impact Axis I or Axis II disorders were accounted for in this axis. These include such things as unemployment, relocation, divorce, or the death of a loved one.

• Axis V: Global Assessment of Functioning
  This axis allowed the clinician to rate the client’s overall level of functioning. Based on this assessment, clinicians could better understand how the other four axes interacted and the effect on the individual’s life.