Axis V is part of the DSM “multi-axial” system for assessment. The five axis model is designed to provide a comprehensive diagnosis that includes a complete picture of not just acute symptoms but of the entire scope of factors that account for a patient’s mental health. This page explains DSM Axis V
Axis V is for Global Assessment of Functioning (GAF), a reflection of the evaluating clinician’s judgement of a patient’s ability to function in daily life. The 100 point scale measures psychological, social and occupational functioning.
From a diagnostic perspective, the GAF takes a practical view of a patient’s mental health. GAF ratings are not only applied to the time the patient enters the doctor’s office but are applied over time to monitor progress; ratings are given for different time frames such as “current” or “past week” along with relative ratings such as “highest level in past year.”
From a healthcare management perspective, the GAF provides quantifiable information that is used to measure eligibility for treatment programs, insurance benefits, disability benefits, etc.
Range of Axis V GAF ratings
The 100 point scale regards the top rating level of 91-100 as “superior functioning,” which essentially identifies a person without symptoms.
At the middle of the scale, a rating of 41-50 is for symptoms that lead to antisocial behaviour (kleptomania) or social dysfunction (inability to keep a job).
The bottom of the scale, 1-10, rates those who pose a threat to themselves or others, who cannot maintain their personal hygiene, or who are suicidal – these patients are mostly dysfunctional on a daily basis and in need of serious help.
An example of a Five axis diagnosis
Axis V is only one of five axes used in a DSM assessment. Here is an example of a five-axis diagnosis from Substance Abuse Assessment and Diagnosis: A Comprehensive Guide for Counsellors and Helping Professionals by Gerald A. Juhnke, Routledge, 2002
Axis I: Adjustment Disorder with Depressed Mood, Alcohol Abuse, Cannabis Abuse
Axis II: No Diagnosis of Axis II
Axis III: Hypothyroidism
Axis IV: None
Axis V: GAF = 50 (on admission), GAF = 62 (on discharge)