Physical Factors Affecting Psychiatric Condition: A Proposal for A Future DSM

Abstract

The advent of DSM III and DSM III-R has improved psychiatric nomenclature considerably in terms of precision and clarity (1-2). The multiaxial system has been very useful in educating nonpsychaitrists that psychiatric conditions often co-exist with medical conditions, or are secondary to them as in organic mental disorders. Consultation-liaison psychiatrists often encounter situations, however, for which there is no appropriate diagnostic entity in DSM III-R. While the diagnosis of Adjustment Disorder might be appropriate for some of these conditions, DSM III-R specifically excludes from the adjustment disorder any condition that has a duration of more than six months. Furthermore, DSM III-R excludes from adjustment disorders syndromes that meet the diagnostic criteria of other major psychiatric disorders such as mood disorders and anxiety disorders.