The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), offers a common language and standard criteria for the classification of mental disorders. It is used, or relied upon, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, the legal system, and policy makers.


The DSM evolved from systems for collecting census and psychiatric hospital statistics, and from a United States Army manual. DSM-IV-TR, was published in 2000. It was organized into a five-part axial system. The first axis incorporated clinical disorders. The second axis covered personality disorders andintellectual disabilities. The remaining axes covered medical, psychosocial, environmental, and childhood factors functionally necessary to provide diagnostic criteria for health care assessments.

It states that 'there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no mental disorder' (APA, 1994 and 2000). There are attempts to adjust the wording for the upcoming DSM-V.

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Sources:
https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29

Axis IV is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders (Axes I and II). 

A psychosocial or environmental problem may be a negative life event, an environmental difficulty or deficiency, a familial or other interpersonal stress, an inadequacy of social support or personal resources, or other problem relating to the context in which a person's difficulties have developed. 

In addition to playing a role in the initiation or exacerbation of a mental disorder, psychosocial problems may also develop as a consequence of a person's psychopathology or may constitute problems that should be considered in the overall management plan.

The problems are grouped together in the following categories:

• Problems with primary support group 

• Problems related to the social environment

• Educational problems

• Occupational problems

• Housing problems

• Economic problems

• Problems with access to health care services

• Problems related to interaction with the legal sys tem/crime

• Other psychosocial and environmental problems

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