Axis I: Clinical Disorders and Other Disorders That May Be a Focus of Clinical Attention Disorders usually first diagnosed

in infancy, childhood, or adolescence (excluding mental retardation) Delirium, dementia, and amnestic and other cognitive disorders Mental disorders due to a general medical condition not elsewhere classified 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 elsewhere classified Adjustment disorders Other conditions that may be a focus of clinical attention Axis II: Personality Disorders and Mental Retardation 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: ICD-9-CM General Medical Conditions Axis III lists any physical disorder or general medical condition that is present in addition to the mental disorder. may be causative (e.g., kidney failure causing delirium) result of a mental disorder (e.g., alcohol gastritis secondary to alcohol dependence) unrelated to the mental disorder

 When a medical condition is causative or causally related to a mental disorder, a mental disorder caused by a general condition is listed on Axis I, and the general medical condition is listed on both Axis I and Axis III. Infectious and parasitic diseases (001-139) Neoplasms (140-239) Endocrine, nutritional, and metabolic diseases and immunity disorders (240-279) Diseases of the blood and blood-forming organs (280-289) Diseases of the nervous system and sense organs (320-389) Diseases of the circulatory system (390-459) Diseases of the respiratory system (460-519) Diseases of the digestive system (520-579) Diseases of the genitourinary system (580-629) Complications of pregnancy, childbirth, and the puerperium (630-676) Diseases of the skin and subcutaneous tissue (680-709) Diseases of the musculoskeletal system and connective tissue (710-739) Congenital anomalies (740-759) Certain conditions originating in the perinatal period (760-779) Symptoms, signs, and ill-defined conditions (780-799) Injury and poisoning (800-999) Axis IV: Psychosocial and Environmental Problems Psychosocial and environmental problems that contribute significantly to the development or exacerbation of the current disorder. Based on a clinician's assessment of the stress that an average person with similar sociocultural values and circumstances would experience from the psychosocial stressors. degree of change that the stressor causes in the person's life degree to which the event is desired and under the person's control number of stressors Stressors can be positive (e.g., a job promotion) or negative (e.g., the loss of a loved one). Problems with primary support group (divorce, abuse, deaths, births, etc.) Problems related to social environment (retirement, living alone/friendships, etc.) Educational problems (illiteracy, academic problems, conflict with teachers, etc.) Occupational problems (unemployment, difficult work conditions, job dissatisfaction, etc) Housing problems (homelessness, unsafe neighborhood, problems with neighbors, etc.) Economic problems (poverty, insufficient finances, etc.) Problems accessing to health care services (inadequate health care, transportation, insurance) Problems related to legal system/crime (arrest, incarceration, or victim of crime, etc.) Other (Disasters, problems with health care providers, etc.)

Axis V Axis V is a global assessment of functioning (GAF) scale in which clinicians judge patients' overall levels of functioning during a particular time (e.g., at the time of the evaluation or the patient's highest level of functioning for at least a few months during the past year). Functioning is considered a composite of three major areas: social functioning, occupational functioning, and psychological functioning. The GAF scale, based on a continuum of mental health and mental illness, is a 100-point scale, 100 representing the highest level of functioning in all areas. Persons who had a high level of functioning before an episode of illness generally have a better prognosis than do those who had a low level of functioning. 91-100 no symptoms superior functioning in a wide range of activities lifes problems never seem to get out of hand is sought by others because of hisher many positive qualities 81-90 minimal symptoms (eg. mild anxiety before an exam), good functioning interested and involved in a wide rage of activities socially effective generally satisfied with life no more than everyday problems/concerns (eg. argument with family members) 71-80 transient symptoms, expectable reactions to psychosocial stressors (eg. difficult concentrating after family argument) no more than slight impairment in social, occupational or school functioning (eg. temporarily falling behind schoolwork) 61-70 mild symptoms (eg. depressed mood and milk insomnia) OR some difficulty in social, occupational or school functioning (eg. occasional truancy, or theft within the household) generally functioning pretty well has some meaningful interpersonal relationships 51-60 moderate symptoms (eg flat affect, circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (eg. few friends, conflicts with peers or co-workers) 41-50 serious symptoms (eg. suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (eg. no friends, unable to keep a job) 31-40 some impairment in reality testing or communication (eg. speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work/school, family relations, judgment, thinking, or mood (eg. depressed man avoids friends, neglects family, unable to work ,child frequently beats up younger children, defiant at home, failing at school) 21-30 behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment

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(eg. sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (eg. stays in bed all day; no job, home, or friends) some danger of hurting self/others (eg. suicide attempts without clear expectation of death, frequently violent, manic excitement) OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communicaiton (eg. stays in bed all day; no job, home or friends) persistent danger or severely hurting self/others (eg. recurrent violence) OR persistent inability to maintain minimal personal hygiene OR seroius suicidal act with clear expectation of death Inadequate information