TO THE EDITOR: In the clinical case conference of the May 1997 issue of The American Journal of Psychiatry (R1558281D), Drs. Panzer and Fullilove usefully remind readers that not all patients may meet formal criteria for mental disorder. The authors describe a patient, Belinda, who was undergoing a crisis due to the pressures of both work and home. The authors concluded that her condition was not a mental disorder but justified a V code—a condition not attributable to a mental disorder that warrants therapeutic attention.

It is important to note, however, that in DSM-IV, the language and definitions for these terms were changed from those in DSM-III-R. Because in some circumstances these conditions are, in fact, attributable or at least related to a mental disorder, a broader conceptualization was applied, and the section was entitled "Other Conditions That May Be a Focus of Clinical Attention." Further, not all of the specific codes included in this section are V-codes—e.g., 316, Psychological Factors Affecting Medical Condition; 313.82, Identity Problem; and 995.5, Physical Abuse of a Child (where the focus of clinical attention is on the victim).