Axis III General Medical Conditions

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On Axis III are listed general medical conditions that may be relevant to the disorder(s) listed on Axes I and II. The presence of Axis III should not be taken to suggest a mind-brain dualism, with Axes I and II representing problems of the mind in the absence of a physiological basis. On the contrary, mental experience is rooted in the function of the brain. Axis III is included in the DSM to encourage a comprehensive evaluation and a consideration of the various ways in which a general medical condition may be related to mental disorders.

There are several ways in which medical conditions may be related to mental disorders. First, the medical condition may be the direct cause of the mental condition. For example, hypothyroidism (Axis III) can lead to a syndrome of depressed mood known as Mood Disorder due to Hypothyroidism (Axis I). Similarly, Alzheimer's Disease (Axis III) produces Dementia of the Alzheimer's type (Axis I), and systemic infections (Axis III) can produce a Delirium (Axis I).

The second manner in which a general medical condition may be relevant to a mental disorder is that the medical condition may be related to the development of the mental disorder, but not through direct physiological means. For example, an Axis I disorder such as Major Depression or Adjustment Disorder with Depressed Mood might follow in reaction to learning of one is diagnosed with a malignant melanoma (Axis III).

Finally, an Axis III medical condition, while not related to the appearance of the symptoms of a mental disorder, might be relevant in the treatment of a disorder. For example, certain antidepressant medications might be ill-advised in the presence of certain cardiovascular conditions. Alternatively, someone with a severe psychosis (Axis I) might have a medical condition (Axis III) that needs careful monitoring or

DSM-IV

treatment (e.g., diabetes), and might be unable to adhere to the treatment without assistance.

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