Adolescent health

Question 1

Adolescence is the name given to the

Answer 1

the psychosocial life stage which starts around the time of puberty;

• considered to span between the ages of 10 and 19 yrs.

Question 2

Adolescent development periods

Answer 2

Early adolescence (10–14 yrs): ‘Am I normal?’

Middle adolescence (14–17 yrs): ‘Who am I?’

Late adolescence (17–19 yrs): ‘Where am I going?

Question 3

Hallmarks of the adolescent

Answer 3

The main hallmarks of the adolescent are:

1. self-consciousness
2. self-awareness
3. self-centredness
4. lack of confidence

Question 4

Needs of the adolescent

Answer 4

Adolescents have basic needs that will allow them the optimal environmental conditions for their development:

• ‘room’ to move
• privacy and confidentiality
• security (e.g. stable home)
• acceptance by peers
• someone to ‘lean on’ (e.g. youth leader)
• special ‘heroes’
• establishment of an adult sexual role
• one good trustworthy friend

Question 5

The clinical approach

Answer 5

Consider the mnemonic HEADS in the history:

H—home

E—education, employment, eating and exercise, economic situation

A—activities, affect, ambition, anxieties

D—drugs including cigarettes and alcohol, depression

S—sex, stress, suicide, self-esteem, safety

Question 6

What are the fundamental development tasks of adolescence?

Answer 6

establishing identity and self-image

emancipation from the family and self-reliance

establishing an appropriate adult sexual role

developing a personal moral code

making career and vocational choices

ego identity and self-esteem

Question 7

Areas of counseling and anticipation guidance that are most relevant are:

Answer 7

emotional problems/depression

significant loss (e.g. breakdown of ‘first’ love)

sexuality

contraception

guilt about masturbation or other concerns

Question 8

Depression, parasuicide, and suicide

Answer 8

Up to 25% suffer from a mental health and/or substance abuse problem, especially anxiety and depression.

Difficult to treat and heavily reliant on a trusting relationship with their GP.

Suicide is the second most common cause of death in this group.

Males successfully complete suicide 4 times more often than females

While females attempt suicide 8–20 times more often than males.

Question 9

Treatment of depression

Answer 9

Non-pharmacological interventions (all grades)

• general support and education
• family therapy
• interpersonal psychotherapy
• CBT

Medication

• mild: not recommended
• moderate to severe: consider fluoxetine 10 mg/d ↑ to 20 mg/d (max: 80); continue for 6–12 mths after recovery

Referral to a psychiatrist is advisable.