What is the significance of the removal of the axial system in DSM-5, and how does it impact the classification and diagnosis of mental disorders compared to previous DSM versions?
The removal of the multiaxial system in the DSM-5 is significant because it represents a shift in how mental health professionals conceptualize, diagnose, and document mental disorders. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition previously used a 5-axis system to give a comprehensive picture of a person’s mental health. Axis I: Clinical disorders such as depression and schizophrenia. Axis II: Personality disorders and intellectual disabilities. Axis II is on General medical conditions encompases diabetes and heart disease. Axis IV is on Psychosocial and environmental factors focuses on housing and job stress. Axis V: Global Assessment of Functioning (GAF) score.
Removal of the axial system in DSM-5
In DSM-5, all diagnoses—mental and medical—are listed together, and the axes were removed. Clinical disorders, personality disorders, and medical conditions are now on a single axis. Psychosocial and environmental problems are captured using V/Z codes from the ICD-10. The GAF score was eliminated, replaced by more specific rating scales (e.g., WHODAS 2.0 for disability).
This change promotes Integrated, Holistic Diagnosis. Combines mental and physical health into one diagnostic framework, reflecting the biopsychosocial model. Encourages clinicians to view a patient’s condition as a whole, rather than separating disorders into arbitrary categories. It combines mental and physical health into one diagnostic framework, reflecting the biopsychosocial model. Encourages clinicians to view a patient’s condition as a whole, rather than separating disorders into arbitrary categories. Additionally, ermoving Axis II helps reduce the stigma associated with personality disorders and intellectual disabilities, which were often seen as “less treatable” or more “ingrained” than Axis I disorders. Simpler structure makes the DSM more user-friendly and clinically practical, especially in integrated care settings. The GAF score was considered too subjective and inconsistent across providers. APA