Use of DSM-III axis IV in clinical practice: rating etiologically significant stressors

This study compared the etiologically significant stressors listed on DSM-III axis IV (severity of psychosocial stressors) with life events elicited by the Psychiatric Epidemiology Research Interview (PERI). Multiaxial evaluations of a diagnostically heterogeneous group of 362 patients were made, and all patients were subsequently administered the PERI by interviewers blind to the clinical assessments. The results indicated that axis IV functions well as a shorthand method for identifying the more severe psychosocial stressors. However, the DSM-III requirement that the stressor be important in the development or exacerbation of the current disorder resulted in discrepancies between the axis IV and PERI assessments.