Multiaxial diagnosis and psychotherapy planning: on the relevance of ICD-10, DSM-IV and complementary schemas.

Abstract

This paper reviews, first, the historical development of multiaxial diagnostic schemas, with particular attention to those designed for the World Health Organisation's Tenth Revision of the International Classification of Diseases (ICD-10) and the American Psychiatric Association's DSM-IV. To complement standardized or nomographic multiaxial schemas, several personalized, or idiographic formulations are outlined, i.e. cultural, biographic, psychodynamic, group dynamic, and one dealing with quality of life. Contributions of comprehensive diagnosis (multiaxial and idiographic formulations) to psychotherapy planning and psychotherapy research are then discussed. The potential contributions of the psychotherapy process to diagnostic verification and clarifications are considered as well. Finally, the need for empirical validation research on the outlined relationships as well as the potential value of exploring further the synergism of nomographic and idiographic approaches are elaborated.