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Transcript 
Axis II V71.09 No diagnosis, histrionic
personality features
Axis III 244.9 Hypothyroidism
Axis IV None
Axis V GAF = 45 (on admission)
GAF = 65 (at discharge)
Hypothyroidism, With Depressive
Features
244.9 Hypothyroidism
365.23 Chronic angle‐closure glaucoma
365.23 Chronic angle‐closure glaucoma
Example 4:
Axis I V61.10 Partner Relational Problem
Axis II V71.09 No diagnosis
Example 4:
Axis III None
V61.10 Partner Relational Problem
Axis IV Unemployment
Axis V GAF = 83 (highest level past year)
(53)
Controversial Changes
The DSM revision process was controversial for a number of reasons. As already discussed,
much of the controversy centered around the way the revision process was conducted, how
the recording system was changed, and the changes and additions that were made to the
specific disorders. The APA received a great deal of backlash regarding its decision to
modify some disorders. In addition, the reorganization and elimination of other disorders
sparked criticism from individuals in the mental health field, both consumers and
practitioners.
While the entire manual was mired in controversy, some changes were more controversial
than others and received more backlash. The APA received the most criticism for changes
it made to specific disorders, including Grief as a Major Depression; Disruptive Mood
Dysregulation Disorder; Mild Neurocognitive Disorder in Seniors; Somatic Symptom
Disorder; Binge Eating; and Asperger’s (34). While the specific reasons differed for each
disorder, critics argued against the changes made to these disorders because of the impact
they had on the diagnosis and treatment of patients (26).
Grief as a Major Depression
In previous editions of the DSM, the depression category specifically excluded grief as one
of the categories of depression. In fact, previous versions included a Bereavement
exclusion that explained that grief that occurred for less than two months as the result of
the loss of a loved one was not considered depression. However, in the DSM-5, the
depression category has been revised to include grief. The bereavement exclusion has
been eliminated.
The DMS-5 provides the following explanation of the addition of grief to the Major
Depression category:
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79
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