Multiaxial Diagnosis: Purposes and Challenges

  • Juan E. Mezzich


The multiaxial approach to comprehensive diagnosis, which constitutes one of the fundamental innovations of modern diagnostic systems, has old roots and antecedents. It can be seen as evolving from the contraposition of an analytic, textural, and experiential Aristotelian perspective to a synthetic, bold, and abstract Platonic conceptualization of disease entity as a sufficient description of a patient’s clinical condition. The ontogeny of multiaxial diagnosis can be understood further, as suggested by Ojesjo (1978) following Nietzschean insights on drama, as the point of convergence between, on the one hand, an idealized and rationalistic Apollonian tradition striving for parsimonial order and clarity, and on the other, a Dionysian tradition, vitalistic, empathetic, and closer to the patient. In this scenario, multiaxial diagnosis can be perceived as an attempt at comprehensiveness and sensitivity in the description of the patient’s condition through a standardized, reliable, and structurally coherent schema.


General Medicine Vocational Rehabilitation American Pathologist Comprehensive Diagnosis Empirical Substantiation 
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© Springer Science+Business Media New York 1994

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  • Juan E. Mezzich

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