The use of DSM-III axis III in recording physical illness in psychiatric patients

The randomly selected charts of 50 discharged psychiatric inpatients were reviewed for documentation of medical illness and DSM-III axis III diagnoses. Twenty-eight percent of the patients had had medical symptoms, 56% had had medical findings, 36% had had laboratory findings, and 60% had been given axis III diagnoses. In at least seven cases, the medical findings were poorly reflected in the final axis III diagnosis. In no case did the record indicate that medical factors were viewed as the cause of a patient's immediate psychiatric syndrome.