Thursday, August 20, 1998
Dr. Vakkur
Psychiatric Assessment: DSM-IV,  Five Axis Formulation
10-10:50 a.m.

 Learning Objectives:  At the end of this lecture, you should be able to:

  - articulate the rationale behind the the development of the Diagnostic & Statistical Manual of the American Psychiatric Association, 4th Edition (DSM-IV), as well as some disadvantages of this system;
  - understand that the DSM-IV is descriptive and attempts to be atheoretical;
  - identify each of the 5 Axes and give a 5 Axis formulation of a sample psychiatric patient:

  Axis I:  major psychiatric disorders;
  Axis II:  developmental disorders, including mental retardation and personality disorders
  Axis III: medical disorders or conditions;
  Axis IV:  psychosocial stressors;
  Axis V:  Global Assessment of Functioning (GAF)

 Lecture Outline:

 1. History of the attempt to classify and define different mental states and psychiatric conditions and the development of the DSM system.
 2. Advantages and Disadvantages of the DSM system.
 3. Description of the DSM-IV, the latest version of the DSM.
 4. Some practical guidelines and caveats about the use and misuse of the DSM-IV.

 Questions for Self-Study:

 1. What do you see as the major advantages and disadvantages of a formal, descriptive diagnostic coding system?   What are the alternatives and what are the disadvantages and advantages of these?
 2. Perform a 5 Axis Formulation on yourself or a significant other.  Is this formulation an accurate description of who you are?