The use of DSM-III in a general hospital consultation-liaison service

Eighteen months' use of DSM-III by a consultation-liaison service in a university hospital is reported. DSM-III's multiaxial system seems to be feasible and revealing, but presents some problems. Adjustment Disorder and Organic Mental Disorders were the most frequent Axis I diagnoses. Approximately one-fourth of the patients received an Axis II diagnosis and 85% received an Axis III diagnosis. In 70% of the patients there was both a psychiatric diagnosis (on Axis I or II) and a physical disorder (on Axis III). On Axis IV and V, this population appeared to be under moderate to severe psychosocial stress and had, as a group, a fair or better level of previous adaptive functioning. The possible significance of these findings and potential areas for further refinements and investigations are discussed.