Merck Manual

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Overview of Psychosocial Problems in Adolescents


Sharon Levy

, MD, MPH, Harvard Medical School

Last full review/revision Sep 2020
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Clinicians must be aware of the high frequency of psychosocial disorders that occur during this stage of life. Screening for mental health disorders is considered a routine part of adolescent health care. Depression Depressive Disorders in Children and Adolescents Depressive disorders are characterized by sadness or irritability that is severe or persistent enough to interfere with functioning or cause considerable distress. Diagnosis is by history and... read more is common and should be screened for actively. Although suicide is a rare occurrence (5/100,000), suicidal ideation Suicidal Behavior in Children and Adolescents Suicidal behavior includes completed suicide, attempted suicide (with at least some intent to die), and suicide gestures; suicidal ideation is thoughts and plans about suicide. Psychiatric referral... read more is common, with as many as 10% of adolescents reporting thoughts about suicide in their lifetime according to some studies. Anxiety Overview of Anxiety Disorders in Children and Adolescents Anxiety disorders are characterized by fear, worry, or dread that greatly impairs the ability to function normally and that is disproportionate to the circumstances at hand. Anxiety may result... read more often manifests during adolescence, as do mood disorders and disruptive behavioral disorders Overview of Behavioral Problems in Children Many behaviors exhibited by children or adolescents concern parents or other adults. Behaviors or behavioral patterns become clinically significant if they are frequent or persistent and maladaptive... read more (eg, oppositional defiant disorder Oppositional Defiant Disorder (ODD) Oppositional defiant disorder is a recurrent or persistent pattern of negative, defiant, or even hostile behavior directed at authority figures. Diagnosis is by history. Treatment is with individual... read more , conduct disorder Conduct Disorder Conduct disorder is a recurrent or persistent pattern of behavior that violates the rights of others or violates major age-appropriate societal norms or rules. Diagnosis is by history. Treatment... read more ). Individuals with thought disorders (psychosis) will often present with a "psychotic break" during adolescence. Eating disorders Introduction to Eating Disorders Eating disorders involve a persistent disturbance of eating or of behavior related to eating that Alters consumption or absorption of food Significantly impairs physical health and/or psychosocial... read more , especially in girls, are common. Some patients go to extraordinary lengths to hide symptoms of an eating disorder.

The clinician who has developed an open, trusting relationship with an adolescent often can identify these problems, develop a therapeutic relationship, offer practical advice and, when appropriate, encourage the adolescent to accept a referral to specialized care.

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NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
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