Using the axis V scale to evaluate therapeutic outcome of psychiatric treatment

This study examined whether the Axis V scale of DSM-III was a useful instrument for coding and evaluating psychiatric patients' response to treatment. It compared outpatients' functional responses to treatment, measured by the Axis V scale used to assess current functioning, with their symptomatic changes. It found that the Axis V scale provided a different dimension of patients' outcome than the symptomatic one. Overall, only 19% of the patients were rated on Axis V as improved functionally, at discharge, as compared to 55% rated as improved symptomatically. However, as outpatients completed more treatment sessions, increasingly larger percentages were rated as improved on the Axis V scale, ranging from 8.5% improved functionally after completing 1-5 sessions to 44.5% improved after 41+ sessions. Symptomatic ratings plateaued after 6-10 sessions, with 80% of the patients being rated as improved symptomatically after completing treatment, no matter how many more treatment sessions they received before discharge. The report discusses the implications of these findings for assessment of psychiatric patients' treatment needs, goals of their treatment programs, and evaluation of treatment outcomes.