VIth axis for DSM-III: Psychodynamic evaluation

DSM-III has raised questions among mental health professionals about the relationship of diagnosis to treatment. Practising psychotherapists have been reluctant to endorse the revised classification, arguing that diagnostic discriminations needed to plan psychotherapy treatment are absent from DSM-III's multiaxial system. The clinical usefulness of a diagnostic classification is a major measure of its validity. The authors illustrate with 3 patients from psychotherapy practice, all with long-standing problems of depressed mood, the limits of DSM-III in planning psychotherapy treatment, and they make suggestions for the development of a treatment-oriented 'axis' to complement the current multiaxial evaluation system.