Mental illness makes a major contribution to the global burden of disease. The impact of disorders such as depression and anxiety has been heightened by the increasing success of public health measures in controlling physical diseases. Mental health disorders are severely impairing in their own right but may also exacerbate the disability resulting from physical disease. The situation will be worse globally as the pattern of morbidity seen in the developed world sweeps over low- and middle-income countries. Mental illness is commonly understood to result from complex interactions between vulnerability and stress, though such a model is uniquely difficult to study, particularly in longitudinal or life course designs. A considerable proportion of individuals who experience mental illness during their lives report the emergence of symptoms and impairment during the adolescent years.
Adolescence is a critical period of accelerated maturation. Individuals differ widely in their rate of physical, social, psychological and sexual development. Physiological changes occurring over the second decade of life include alterations in gonadal hormone levels as well as significant elevations in glucocortioids resulting in physical maturation. There are also changes in psychological functions associated with brain development such as cognitive control of emotions, greater reasoning skills and problem solving ability. These changes occur within the contexts of peer groups, school and family settings, each of which has been shown to have an important impact on individual development.
A striking feature of this period is the emergence of major mental illness, such as depressive, anxiety, eating and behaviour disorders and psychoses, some of which have their genesis earlier in childhood. Early onset carries considerable risk for continuity and recurrence into adult life. In particular, rates of depression and suicide rise alarmingly over the adolescent period. The co-occurrence of two or more diagnoses is the rule rather than the exception. Likewise, gender is of considerable importance as there are markedly emerging sex differences in the incidence of emotional disorders (females males) in the adolescent period. In contrast, the known ratio of three males for every female in childhood conduct disorder contrasts with an almost equal sex ratio for cases beginning in the adolescent years.
Read Full Article (PDF)
________________________________________
