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Patterns and issues in multiaxial psychiatric diagnosis1

Published online by Cambridge University Press:  09 July 2009

Juan E. Mezzich
Juan E. Mezzich*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA
*
2Address for correspondence: Dr Juan E. Mezzich, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, Pa 15261, USA.
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Synopsis

The multiaxial diagnostic model, consisting in the systematic formulation of a patient's condition according to separate clinical variables or aspects, is receiving increasing attention in several parts of the world. This innovative model promises to improve diagnostic reliability and validity and involves many methodological challenges. This paper reviews patterns and issues in the conceptualization of axial content, number and organization of axes, dimensional versus categorical scaling, and evaluation and further development of multiaxial systems.

Type
Research Article
Information
Psychological Medicine , Volume 9 , Issue 1 , February 1979 , pp. 125 - 137
Copyright
Copyright © Cambridge University Press 1979

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Footnotes

1

This paper was presented at the VI World Congress of Psychiatry, Symposium on Multiaxial Systems of Classification in Psychiatry, Honolulu, Hawaii, August 1977.

References

Amati, A., Del Vecchio, M., Kemali, D., Perris, C. & Vacca, L. (1977). Communicability and reliability of a multiaxial classification model for the description of psychiatric patients. A pilot international study (submitted for publication).Google Scholar
American Psychiatric Association Task Force on Nomenclature and Statistics (1978). Diagnostic and Statistical Manual of Mental Disorders (3rd edn.) (DSM-III draft). Washington, D.C.Google Scholar
Cantwell, D. (1977). A DSM-III field trial and reliability study. Paper presented at the 130th Annual Meeting of the American Psychiatric Association, Toronto, Canada.Google Scholar
Chernoff, H. (1973). The use of faces to represent points in k-dimensional space graphically. Journal of the American Statistical Association 68, 361–368.CrossRefGoogle Scholar
Cohen, J. (1960). A coefficient for agreement for nominal scales. Educational and Psychological Measurement 20, 37–46.CrossRefGoogle Scholar
Essen-Möller, E. (1961). On classification of mental disorders. Acta Psychiatrica Scandinavica 37, 119–126.CrossRefGoogle Scholar
Essen-Möller, E. (1971). Suggestions for further improvement of the international classification of mental disorders. Psychological Medicine 1, 308–311.CrossRefGoogle ScholarPubMed
Essen-Möller, E. & Wohlfahrt, S. (1947). Suggestions for the amendment of the official Swedish classification of mental disorders. Acta Psychiatrica Scandinavica Supplement 47, 551–555.CrossRefGoogle Scholar
Harman, H. H. (1967). Modern Factor Analysis (2nd edn.). University of Chicago Press: Chicago.Google Scholar
Helmchen, H. (1975). Schizophrenia. Diagnostic concepts in the ICD-8. In Studies in Schizophrenia (ed. Lader, M. H.), pp. 10–18. British Journal of Psychiatry, Special Publication no. 10.Google Scholar
Johnson, S. C. (1967). Hierarchical clustering schemes. Psychometrika 32, 241–254.CrossRefGoogle ScholarPubMed
Kato, M. (1977). Multiaxial diagnosis in adult psychiatry. Paper presented at the VI World Congress of Psychiatry, Honolulu, Hawaii.Google Scholar
Kendell, R. E. (1975). The Role of Diagnosis in Psychiatry. Blackwell: Oxford.Google Scholar
Kruskal, J. B. (1964). Multidimensional scaling by optimizing goodness of fit to a non-metric hypothesis. Psychometrika 29, 1–27.CrossRefGoogle Scholar
MacQueen, J. B. (1967). Some methods for classification and analysis of multivariate observations. Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability 1, 281–297.Google Scholar
Mezzich, J. E. (1977 a). A comprehensive comparison of cluster analytic methods. Invited paper presented at the National Science Foundation Workshop on Classifying Social and Cultural Data, Charleston, South Carolina.Google Scholar
Mezzich, J. E. (1977 b). Assessing the structure of diagnostic entities. Paper presented at the VI World Congress of Psychiatry, Honolulu, Hawaii.Google Scholar
Mezzich, J. E. (1978). Evaluating clustering methods for psychiatric diagnosis. Biological Psychiatry 13, 265–281.Google ScholarPubMed
Mezzich, J. E., Keener, M. A., Kraemer, H. C. & Worthington, D. R. L. (1978). Comparative reliability of three psychiatric diagnostic systems. Technical Report: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.Google Scholar
Ottosson, J. O. & Perris, C. (1973). Multidimensional classification of mental disorders. Psychological Medicine 3, 238–243.CrossRefGoogle ScholarPubMed
Raven, P. H., Berlin, B. & Breedlove, D. E. (1971). The origins of taxonomy. Science 174, 1210–1213.CrossRefGoogle ScholarPubMed
Rutter, M., Lebovici, S., Eisenberg, L., Sneznevskij, A. V., Sadoun, R., Brooke, E. & Lin, T.-Y. (1969). A tri-axial classification of mental disorders in childhood. Journal of Child Psychology and Psychiatry 10, 41–61.CrossRefGoogle ScholarPubMed
Rutter, M., Shaffer, D. & Shepherd, M. (1975 a). A Multiaxial Classification of Child Psychiatric Disorders. World Health Organization: Geneva.Google Scholar
Rutter, M., Shaffer, D. & Sturge, C. (1975 b). A Guide to a Multiaxial Classification Scheme for Psychiatric Disorders in Childhood and Adolescence. Institute of Psychiatry: London.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research diagnostic criteria. Archives of General Psychiatry 35, 773–782.CrossRefGoogle ScholarPubMed
Stengel, E. (1959). Classification of mental disorders. Bulletin of WHO 21, 601–663.Google ScholarPubMed
Strauss, J. S. (1973). Diagnostic models and the nature of psychiatric disorder. Archives of General Psychiatry 29, 445–449.CrossRefGoogle ScholarPubMed
Strauss, J. S. (1975). A comprehensive approach to psychiatric diagnosis. American Journal of Psychiatry 132, 1193–1197.Google ScholarPubMed
Strauss, J. S., Bartko, J. J. & Carpenter, W. T. (1973). The use of clustering techniques for the classification of psychiatric patients. British Journal of Psychiatry 122, 531–540.CrossRefGoogle ScholarPubMed
von Cranach, M. (1977). Categorical v. multiaxial classification. Paper presented at the VI World Congress of Psychiatry, Honolulu, Hawaii.Google Scholar
von Knorring, L., Perris, C. & Jacobsson, L. (1977). A multiaxial classification of mental disorders. Experiences from clinical routine work and preliminary studies of interrater reliability. Paper presented at the VI World Congress of Psychiatry, Honolulu, Hawaii.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, L. (1970). Observations on the psychiatric section of the International Classification of Diseases and the British Glossary of Mental Disorders. Psychological Medicine 1, 79–85.CrossRefGoogle ScholarPubMed
Wolfe, J. H. (1970). Pattern clustering by multivariate mixture analysis. Multivariate Behavioral Research 5, 329–350.CrossRefGoogle ScholarPubMed
Zeh, W. (1962). Bemerkungen zu einem Klassificationsvorschlag der psychischen Störungen von Erik Essen-Möller, Lund. Nervenarzt 33, 404–410.Google Scholar
Ziskind, E. (1965). Some nosologic concepts related to mental diseases. Acta Psychiatrica Scandinavica 41, 303–312.CrossRefGoogle ScholarPubMed