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Overview of Psychosocial Problems in Adolescents

By Sharon Levy, MD, MPH, Harvard Medical School;Children's Hospital, Boston

Psychologic and social problems, particularly involving behavior and school issues, are more common during adolescence than at any other time during childhood. Adolescents are much more independent and mobile and are often out of the direct control of adults. When misbehavior becomes severe and frequent, adolescents should be evaluated for a psychosocial disorder by a mental health professional. In particular, depression, anxiety, and eating disorders are common during adolescence. Adolescents who have psychosocial problems, anxiety, or depression may have physical symptoms such as fatigue or chronic fatigue, dizziness, headache, and abdominal or chest pain.

Depression is common among adolescents, and doctors actively screen for it during examinations (see Depression in Children and Adolescents). Suicide (see Suicidal Behavior in Children and Adolescents) is rare, but thoughts about suicide (called suicidal ideation) are more common. Suicidal ideation may go unnoticed, but, once it is noticed, the adolescent should receive a mental health evaluation.

Anxiety often manifests during adolescence (see Overview of Anxiety Disorders in Children), as do mood disorders and disruptive behavioral disorders such as oppositional defiant disorder (see Oppositional Defiant Disorder) and conduct disorder (see Conduct Disorder). Thought disorders (called psychosis—see also Childhood Schizophrenia) most commonly begin during adolescence or early adulthood. The first episode of psychosis is called a psychotic break.

Eating disorders, especially in girls, are common (see Definition of Eating Disorders). Some adolescents go to extraordinary lengths to hide symptoms of an eating disorder.

Doctors can often identify these problems. They can offer adolescents practical advice and, when appropriate, encourage adolescents to accept treatment provided by specialists.

* This is the Consumer Version. *