The DSM

The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is a piece of text published by the American Psychiatric Association, which provides criteria from which mental disorder can be diagnosed. First published in 1952, the DSM has had over five revisions. The most recent edition is the DSM-V.

The DSM system was developed in response to the need for a census of mental health disorders.

This guide is based on five axis:

Axis 1: Considers clinical disorders, major mental disorders, developmental disorders and learning disorders. An example of the disorders found includes schizophrenia.

Axis 2: Looks at underlying personality conditions, including mental retardation. An example of the disorders found in this axis include obsessive-compulsive disorder.

Axis 3: Considers general medical conditions, as the symptoms of some medical disorders are similar to mental disorders. An example of this would be hypothyroidism (an underactive thyroid), which mimics the symptoms of depression (i.e. fatigue).

Axis 4: Looks at psychosocial and environmental problems, which may have an effect on the disorder. An example of this would be issues within the family. This may contribute to the disorder.

Axis 5: The Global Assessment of Functioning (GAF) scale, which ranges from 0 to 100. The psychiatrist has to assess how able the patient is to cope with everyday life, and so how urgent their treatment is. Someone with a high score (i.e. 100) is said to be functioning perfectly, whereas an individual with a low score (i.e. 30) is said to have serious problems in several areas of their life.

Example of diagnosis from Davidson and Neale (1994):

“Alex was assessed after having been arrested for sexually assaulting a woman when he was drunk. He had been almost continually drunk for the past four years, since his daughter was killed in a accident. He now has liver damage. It was also found that he had a history of gang violence and domestic violence. He showed no remorse about any of his actions.”

Axis 1: Alcohol Dependence

Axis 2: Anti-Social Personality Disorder

Axis 3: Liver Damage

Axis 4: Arrest, Death of his child

Axis 5: 42

You may also need to be aware of the International Statistical Classification of Diseases and Related Health Problems (ICD), which is used more often than the DSM in some parts of the world.

Sources:

– Brain, C. (2009). Edexcel A2 psychology. London: Edexcel

– Brain, C. (2009). Edexcel A2 psychology. London: Philip Allan