Mulder RT, Joyce PR, Frampton CM.
University of Otago, Christchurch, New Zealand.
Acta Psychiatr Scand 2010;122:219–25.
Editor’s note: Ever since the introduction in the DSM-III of multiaxial psychopathology with separate Axis I and Axis II diagnoses, the relationship between these two axes has been at the center of discussion for clinicians. One of the main differences between the axes relates to the course of illness. While Axis I diagnoses, in particular affective disorders, are thought to be characterized by an episodic course with symptom-free episodes inbetween, Axis II disorders are by definition stable over time with an onset in early adulthood. Research has proved that this dichotomy in the course of illness is not clear. Axis I disorders such as depression and bipolar disorder are increasingly recognized as chronic and recurrent, with residual symptoms remaining between episodes of illness. Similarly, the evidence for stability of symptoms of Axis II disorders is limited at best.