The development of multiaxial diagnosis has provided a framework for systematically considering biologic, psychologic, and social characteristics of psychopathology in a systems context. The axes have been operationally defined to help ensure their usefulness and to avoid the vagueness sometimes associated with systems approaches in psychiatry. But there is evidence suggesting that the axes represent open-linked systems; that is, they are partially related as well as partially independent. To improve the diagnostic system it is therefore essential to clarify patterns of relationships among axes as well as specify areas of independence. This study is designed to explore empirically the relationships between two diagnostic axes, axis five, social competence, and axis one, psychiatric syndromes. Using an interactive research approach involving both qualitative and quantitative descriptive methods in a series of large N and small N studies of psychiatric patients, an attempt will be made to begin clarifying the nature of the links between the social competence axis (in terms of two components, work and social relationships) and the syndrome axis with its component symptoms. In this way, it is hoped to refine the definition of the axes themselves, and to suggest what patterns of relationships across axes exist that have implications for the further development of multiaxial diagnostic systems in psychiatry.
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