Basics The 5 Axes of the DSM-IV Multi-Axial System By Nancy Schimelpfening Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial process Updated on February 04, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Mental disorders are diagnosed according to a manual published by the American Psychiatric Association called the Diagnostic and Statistical Manual of Mental Disorders. A diagnosis under the fourth edition of this manual, which was often referred to as simply the DSM-IV, had five parts, called axes. Each axis of this multi-axial system gave a different type of information about the diagnosis. Verywell / Nusha Ashjaee Changes With DSM-5 When the fifth edition, the DSM-5, was compiled, it was determined that there was no scientific basis for dividing the disorders in this manner, so the multi-axial system was done away with. Instead, the new non-axial diagnosis combines the former Axes I, II and III and include separate notations for the type of information which would have previously fallen into Axes IV and V. DSM-IV Types of Axes By Disorder Axis I provided information about clinical disorders. Any mental health conditions, other than personality disorders or mental retardation, would have been included here. Disorders which would have fallen under this axis include: Disorders Usually Diagnosed in Infancy, Childhood or Adolescence Delirium, Dementia and Amnestic and Other Cognitive Disorders Mental Disorders Due to a General Medical Condition Substance-Related Disorders Schizophrenia and Other Psychotic Disorders Mood Disorders Anxiety Disorders Somatoform Disorders Factitious Disorders Dissociative Disorders Sexual and Gender Identity Disorders Eating Disorders Sleep Disorders Impulse-Control Disorders Not Else Classified Adjustment Disorders Other Conditions That May Be a Focus of Clinical Attention Axis II provided information about personality disorders and mental retardation. Disorders which would have fallen under this axis include: Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder Personality Disorder Not Otherwise Specified Mental Retardation Axis III provided information about any medical conditions that were present which might impact the patient's mental disorder or its management. Axis IV was used to describe psychosocial and environmental factors affecting the person. Factors which might have been included here were: Problems with a primary support groupProblems related to the social environmentEducational problemsOccupational problemsHousing problemsEconomic problemsProblems with access to health care servicesProblems related to interaction with the legal system/crimeOther psychosocial and environmental problems Axis V was a rating scale called the Global Assessment of Functioning; the GAF went from 0 to 100 and provided a way to summarize in a single number just how well the person was functioning overall. A general outline of this scale would be as follows: 100: No symptoms90: Minimal symptoms with good functioning80: Transient symptoms that are expected reactions to psychosocial stressors70: Mild symptoms or some difficulty in social occupational or school functioning60: Moderate symptoms or moderate difficulty in social, occupation or school functioning50: Serious symptoms or any serious impairment in social occupational or school functioning40: Some impairment in reality testing or communication or major impairment in several areas such as work or school, family relations, judgment, thinking or mood30: Behavior is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment or inability to function in almost all areas20: Some danger of hurting self or others or occasionally fails to maintain minimal personal hygiene or gross impairment in communication10: Persistent danger of severely hurting self or others or persistent inability to maintain minimal personal hygiene or serious suicidal act with clear expectation of death Was this page helpful? Thanks for your feedback! Ever wonder what your personality type means? Sign up to find out more in our Healthy Mind newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 1 Source Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Substance Abuse and Mental Health Services Administration. DSM-IV to DSM-5 Changes: Overview. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK519711/. Additional Reading American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC: American Psychiatric Association, 1994. Kress, Victoria E. et. al. "The Removal of the Multiaxial System in the DSM-5: Implications and Practice Suggestions for Counselors." The Professional Counselor. National Board for Certified Counselors and Affiliates, Inc. Published: July 2014. Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.