16 Introduction
reason that the criteria are not met for a sp ecific disorder, then “unspecified depressive
disorder” would be diagnosed. Note that th e differentiation between other specified and
unspecified disorders is based on the clinic ian’s decision, providing maximum flexibility
for diagnosis. Clinicians do not have to diff erentiate between other specified and unspec-
ified disorders based on some feature of the presentation itself. When the clinician deter-
mines that there is evidence to specify the na ture of the clinical presentation, the other
specified diagnosis can be given. When the clinician is not able to further specify and de-
scribe the clinical presentation, the unspecifie d diagnosis can be given. This is left entirely
up to clinical judgment.
For a more detailed discussion of how to us e other specified and unspecified designa-
tions, see “Use of the Manual” in Section I.
The Multiaxial System
Despite widespread use and its adoption by certain insurance and governmental agencies,
the multiaxial system in DSM-IV was not requ ired to make a mental disorder diagnosis. A
nonaxial assessment system was also included that simply listed the appropriate Axis I, II,
and III disorders and conditio ns without axial designations. DSM-5 has moved to a nonax-
ial documentation of diagnosis (formerly Axes I, II, and III), with separate notations for
important psychosocial and contextual factors (formerly Ax is IV) and disability (formerly
Axis V). This revision is consistent with the DSM-IV text that states, “The multiaxial dis-
tinction among Axis I, Axis II, and Axis III disorders does not imply that there are funda-
mental differences in their conceptualizatio n, that mental disorders are unrelated to
physical or biological factors or processes, or  that general medical conditions are unrelated