Admission decisions and multiaxial diagnosis

We comparatively examined the relevance of the various components of an expanded DSM-III diagnostic formulation to admission decisions by studying all 745 new patients who came to a 24-hour walk-in clinic during a six-month period and who were admitted to either inpatient or outpatient care at a comprehensive psychiatric institute. A diagnosis of psychotic disorders was found to be significantly associated with hospitalization, while anxiety disorders, adjustment disorders, personality disorders, and nonmental disorder conditions were associated with outpatient referral. The strongest correlations with hospitalization, however, were obtained for current adaptive functioning and, to a lesser extent, for highest level of adaptive functioning in the past year.