Abstract
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.
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References
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, Third Revision (DSM-III). American Psychiatric Association, Washington, DC.
Basset AS, Beiser M (1991). DSM-III: Use of the multiaxial diagnostic system in clinical practice. Canadian Journal of Psychiatry 36:270–274.
Bech P, Jhorts S, Lund K, Vilmar T, Kastrup M (1987). An integration of the DSM-III and ICD-8 by global severity assessments for measuring multidimentional outcomes in general hospital psychiatry. Acta Psychiatrica Scandinavica 75:297–306.
Bilikiewicz T (1951). Proba ukladu nozograficznego etioepigenetycznego w psychiatrii. Neurologia i Neurochirurgia Polska 1:68–78 (in Polish).
Bramer GR (1988). 10th Revision of the International Classification. British Journal of Psychiatry 152:29–32 (suppl 1).
Clare A, Gulbinat W, Sartorius N (1992). A triaxial classification of health problems presenting in primary care: A World Health Organization multicentre study. Social Psychiatry and Psychiatric Epidemiology 27:108–116.
College of American Pathologists (1965). Systematized Nomenclature of Pathology (SNOP). College of American Pathologists, Chicago.
College of American Pathologists (1977). Systematized Nomenclature of Medicine (SNOMED). College of American Pathologists, Skokie, IL.
Essen-Möller E, Wohlfahrt S (1947). Suggestions for the amendment of the official Swedish classification of mental disorders. Acta Psychiatrica Scandinavica 47:551–555.
Feinstein AR (1988). ICD, POR, and DRG: Unsolved scientific problems in the nosology of clinical medicine. Archives of Internal Medicine 148:2269–2274.
Fernando T, Mellsop G, Nelson K, Peace K, Wilson J (1986). The reliability of the Axis V of the DSM-III. American Journal of Psychiatry 143:752–755.
Helmchen H (1975). Schizophrenia: Diagnostic concepts in the ICD-8. British Journal of Psychiatry No. 10 (special pub).
Helmchen H (1980). Multiaxial systems of classification. Acta Psychiatrica Scandinavica 61:43–55.
House JS, Landis KR, Umberson D (1988). Social relationships and health. Science 241:540–544.
Jenkins R, Smeeton N, Shepherd M (1988). Classification of mental problems in primary care. Psychological Medicine 12:1–69 (suppl).
Kaplan HI, Sadock BJ (eds) (1989). Comprehensive Textbook of Psychiatry (5th ed). Williams & Wilkins, Baltimore.
Lecomte M, Damey A, Delage E, Marty P (1947). Essai d&3x2019;une statistique synoptique de médicine psychiatrique. Techniques Hospitallers 18:5–8.
Leme Lopes J (1954). As Dimensōes do Diagnostico Psiquiátrico. Agir, Rio de Janeiro.
Mezzich JE (1979). Patterns and issues in multiaxial diagnosis. Psychological Medicine 9:125–137.
Mezzich JE (1988). On developing a psychiatric multiaxial schema for ICD-10. British Journal of Psychiatry 152:38–43 (Suppl 1).
Mezzich JE (1990). The World Psychiatric Association and the development of ICD-10. In C Stefanis, AD Rabavilas, CR Soldatos (eds), Psychiatry: A World Perspective. Elsevier Science Publishers, Amsterdam.
Mezzich JE, Coffman GA, Goodpastor SM (1982). A format for DSM-III diagnostic formulation: Experience with 1111 consecutive patients. American Journal of Psychiatry 139:591–596.
Mezzich JE, Evanczuk KJ, Mathias RJ, Coffman GA (1984). Admission decisions and multiaxial diagnosis. Archives of General Psychiatry 41:1001–1004.
Mezzich JE, Kleinman A, Fabrega H, Parron D (eds) (in press). Culture and Psychiatric Diagnosis. American Psychiatric Press, Washington, DC.
Mezzich JE, Sartorius N, Kastrup MC, Katschnig H, Lopez-Ibor JJ, Janca A (1993). Paper presented at the WHO Symposium on ICD-10: A Common Language, Annual Meeting of the American Psychiatric Association, San Francisco, May 25, 1993.
Ojesjo L (1978). Psychiatric classification and diagnosis: Some guidelines. Nordisk Psykiatrisk Tidsskrift 32:239–250.
Ottoson JO, Perris C (1973). Multidimensional classification of mental disorders. Psychological Medicine 3:238–243.
Percy C, van Holten V, Muir C (1990). International Classification of Diseases for Oncology]. World Health Organization, Geneva
Rutter M, Shaffer D, Shepherd M (1975). A Multiaxial Classification of Child Psychiatric Disorders. World Health Organization, Geneva.
Rutter M, Levovici S, Eisenberg L, et al (1969). A triaxial classification of mental disorders in childhood. Journal of Child Psychology and Psychiatry 10:41–61.
Shepherd M (ed) (1985). Handbook of Psychiatry. Cambridge University Press, Cambridge.
Wenger N, Mattson M, Furberg C, Elinson J (eds) (1984). Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapies. Le Jacq Publishing, New York.
Williams JBW (1987). Multiaxial diagnosis. In AE Skodol, RL Spitzer (eds), An Annotated Bibliography of DSM-III. American Psychiatric Press, Washington, DC.
Williams JBW, Goldman H, Gruenberg A, Mezzich JE, Skodol AE, Shaffer D, Spitzer RL, Setterberg S (1990). Towards DSM-IV: The multiaxial system in progress. Hospital and Community Psychiatry 41:1181–1182.
Wilson M (1993). DSM-III and the transformation of American psychiatry: A history. American Journal of Psychiatry 150:399–410.
World Health Organization (1985). Disabilities Assessment Schedule. World Health Organization, Geneva.
World Health Organization (1992). ICD-10 classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, Geneva.
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Mezzich, J.E. (1994). Multiaxial Diagnosis: Purposes and Challenges. In: Mezzich, J.E., Kastrup, M.C., Honda, Y. (eds) Psychiatric Diagnosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-0857-0_17
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DOI: https://doi.org/10.1007/978-1-4612-0857-0_17
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