DSM-III axis IV revisited.

Clinicians have traditionally inquired about stressful life events preceding the onset of a psychiatric disorder. Axis IV of DSM-III attempted to improve on this by suggesting that a wide range of events be considered and that the information obtained be integrated into a global rating of severity. After reviewing recent evidence, the authors suggest that this process might result in ratings with lower reliability than expected. They also discuss some of the methodological difficulties in this field and explore directions for further research.