Axis IV refers to the diagnostic axis of the DSM-IV that specifies any psychosocial or environmental problems relevant to diagnosis, treatment, and prognosis.

Using the DSM-IV-TR classification system, psychosocial and environmental problems are recorded on Axis IV - Psychosocial and Environmental Problems - is for reporting psychosocial and environmental stressors that may affect the diagnosis, treatment, and prognosis of mental disorders. A psychosocial or environmental problem may be a negative life event, an environmental difficulty or deficiency, a familial or other interpersonal stressor, an inadequacy of social support of personal resources, or other problems relating to the context in which an individual's difficulties have developed.

Psychosocial and Environmental Problems fall into nine (9) categories :

1. Problems with primary support group

2. Problems related to the social environment

3. Educational problems

4. Occupational problems

5. Housing problems

6. Economic problems

7. Problems with access to health care services

8. Problems related to interaction with the legal system/crime

9. Other psychosocial and environmental problems.