Psychiatry of adolescence

Psychiatric disorder is present in 15-20 per cent of adolescents. 'Adolescent turmoil' (identity crisis), when the process of maturation involves mood swings, rebellious behaviour, or experimentation with contrasting lifestyles, is a common phenomenon that may be confused with psychiatric illness.

Schizophrenia, affective disorders, neuroses, eating disorders, substance misuse, and deliberate self-harm may all begin during adolescence, and personality disorders may become clearly evident at this time. Drug misuse and completed suicide in adolescents are becoming increasingly common.

Distinguishing adolescents with formal psychiatric illness from those whose problems stem from disturbance of adjustment and relationships, or substance misuse, can require prolonged observation.

Treatment of seriously disturbed adolescents may be carried out in a residential unit. Length of stay is usually several months and treatment methods are predominantly psychotherapeutic, whether or not involving the patient's family.

Reference

NICE (National Institute for Health and Clinical Excellence) (2005). Depression in children and young people. www.nice.org.uk/CG028.

Further reading

Barker, P. (2004). Basic Child Psychiatry (7th edn). Oxford: Blackwell Scientific. Viner, R. (2005). ABC of Adolescence. Oxford: Blackwell/BMJ Books.

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