title: Axis IV--psychosocial and environmental problems--in the DSM-IV.
abstract: The aim of this study was to further explore the properties of axis IV in the Diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV). In a naturalistic cross-sectional design, a group (n = 163) of young (18-25 years old) Swedish psychiatric outpatients was assessed according to DSM-IV. Psychosocial and environmental problems/axis IV were evaluated through structured interviewing by a social worker and by self-assessment on a questionnaire. Reliability between professional assessment and self-assessment of axis IV was examined. Concurrent validity of axis IV was also examined. Reliability between professional and self-assessed axis IV was fair to almost perfect, 0.31-0.83, according to prevalence and bias-adjusted kappa. Categories of psychosocial stress and environmental problems were related to the presence of axis I disorders, co-morbidity, personality disorders and decreasing Global Assessment of Functioning (GAF) values. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability.
authors.affiliation: Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Ramirez
authors.forename: L
authors.initials: L
authors.lastname: Ekselius
authors.forename: M
authors.initials: M
authors.lastname: Ramklint
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012647:Self-Assessment; D012931:Social Environment; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D013548:Sweden; D055815:Young Adult
keywords: DSM-IV; assessment; axis IV; concurrent validity; psychosocial stress; young adults