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ICD 10 Multiaxial System

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In multi-axial diagnosis, a patient’s problems are viewed within a broader context, which includes clinical diagnosis, assessment of disability, and psychosocial factors. In ICD-10, multi-axial diagnoses are made along three axes, as follows:

Axis I: clinical diagnoses

This includes all disorders, both psychiatric and physical, including learning disability and personality disorders. 

Axis II: disabilities

Conceptualized in line with WHO definitions of impairments, disabilities, and handicaps, this covers a number of specific areas of functioning that are rated on a scale of 0–5 (‘no disability’ to ‘gross disability’):

Personal care: personal hygiene, dressing, feeding, etc.

Occupation: expected functioning in paid activities, studying, homemaking, etc.

Family and household: participation in family life.

Functioning in a broader social context: participation in the wider community, including contact with friends, leisure, and other social activities. 

Axis III: contextual factors

The factors considered to contribute to the occurrence, presentation, course, outcome, or treatment of the present Axis I disorder(s). They include problems related to:

Negative events in childhood.

Education and literacy.

Primary support group, including family circumstances.

Social environment.

Housing or economic circumstances.

(Un)employment.

Physical environment.

Certain psychosocial circumstances.

Legal circumstances.

Family history of disease or disabilities.

Lifestyle or life-management difficulties.
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