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 is common and should be screened for actively. Suicidal ideation is also common, and as many as 18.8% of adolescents in the US reported thoughts about suicide in their lifetime (1). Suicide occurred in < 10/100,000 in the US in 2018 (1). Anxiety often manifests during adolescence, as do mood disorders and disruptive behavioral disorders (eg, oppositional defiant disorder, conduct disorder). The COVID-19 pandemic and the global response to it, including disruptions in home and school schedules, have increased the rates of depression and anxiety among adolescents. Individuals with thought disorders (psychosis) will often present with a "psychotic break" during adolescence. Eating disorders, 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.
General reference
1. Underwood JM, Brener N, Thornton J, et al: Youth Risk Behavior Surveillance—United States, 2019. MMWR Suppl 69(1):1–83, 2020. doi: 10.15585/mmwr.su6901a1
