Spitzer R L, Forman J B
Am J Psychiatry. 1979 Jun;136(6):818-20. doi: 10.1176/ajp.136.6.818.
The multiaxial system of DSM-III includes nondiagnostic data that are valuable in understanding possible etiological factors and in treatment planning and prognosis. The authors describe the reliability of axis IV--severity of psychosocial stressors--and axis V--highest level of adaptive functioning in the past year--for 281 adult patients interviewed in phase one of the DSM-III field trials. The kappa coefficient of agreement for axis IV was .62 for joint interviews and .58 for separate interviews, which the authors consider at least fair. Reliability for axis V was quite good, .80 for joint interviews and .69 for separate interviews. Eighty-one percent of the participating clinicians judged the multiaxial system to be a useful addition to traditional diagnostic evaluation, although many indicated that they had difficulty quantifying severity of psychosocial stressors.
《精神疾病诊断与统计手册》第三版（DSM-III）的多轴系统包含一些非诊断性数据，这些数据对于理解可能的病因、制定治疗计划以及判断预后具有重要价值。作者描述了在DSM-III现场试验第一阶段接受访谈的281名成年患者中，轴IV（心理社会应激源的严重程度）和轴V（过去一年的最高适应功能水平）的可靠性。对于轴IV，联合访谈的kappa一致性系数为0.62，单独访谈为0.58，作者认为这至少还算不错。轴V的可靠性相当好，联合访谈为0.80，单独访谈为0.69。81%的参与临床医生认为多轴系统是对传统诊断评估的有益补充，尽管许多人表示他们难以量化心理社会应激源的严重程度。
