Practical aspects of multiaxial classification: A clinically useful biopsychosocial framework for child and adolescent psychiatry

Mayall, Mark, McDermott, Brett, Sadhu, Raja, Teoh, Yvonne, Bosanquet, Margot, and Nundeekasen, Sunaina (2024) Practical aspects of multiaxial classification: A clinically useful biopsychosocial framework for child and adolescent psychiatry. BJPsych Advances. (In Press)

PDF (Publisher Accepted Version) - Published Version
Available under License Creative Commons Attribution.

Download (527kB) | Preview
View at Publisher Website:


Summary: Multiaxial classification system development (organising important and relevant clinical factors under multiple headings or 'axes') has a long history stretching back to the 1940s. The World Health Organization supported the development of a multiaxial system of classification for children from the 1960s and in the 1990s produced a comprehensive multiaxial system which could be used with ICD-10. Using the multiaxial approach provides for an atheoretical framework that can integrate factors from within the child and the environmental influences on the child. This article presents a variety of ways in which the ICD-10 multiaxial framework can be extended from its classic usage to provide clinicians with valuable tools to assist in a biopsychosocial clinical assessment. Using the multiaxial system in an extended format allows a more comprehensive diagnosis and planning of treatments and is helpful in the training and teaching of juniors. It is also useful in evaluating responses to medication when it is combined with a chronological analysis and can provide other useful ways of integrating information relevant to understanding clinical cases.

Item ID: 80360
Item Type: Article (Research - C1)
ISSN: 2056-4678
Keywords: application of multiaxial classification system, biopsychosocial, child and adolescent psychiatry, history of multiaxial classification system, Multiaxial classification
Copyright Information: © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Date Deposited: 06 Feb 2024 02:21
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320221 Psychiatry (incl. psychotherapy) @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200199 Clinical health not elsewhere classified @ 100%
Downloads: Total: 16
Last 12 Months: 14
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page