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Psychiatric Problems Emerging in Teens: The Situation for the Design of Future Interventions

Federico Amianto and Secondo Fassino

Introduction
High levels of psychopathological endure in adolescent
population have been display in the last few years all
over the western world. A specific attention to here
issue is needed to design an efficacious precaution and
put forth adequate therapeutic strategies. Both the
family and the medical management. system should be
involved since they represent critical nodes of the net of
care which can support adolescents in their
development.
Psychopathological problems of the teenagers are
growing in Italy and in westernized world. Many
authors have wondered why there is an exponential
increase in the diagnosis of many psychiatric
disorders in adolescent population. It seems that a
competitive society as the contemporary one represents
a heavily stressful environment for adolescents’
expansion. Nevertheless, give blame to social cues does
not represent a way out from a social issues which
needs proper analysis, an in depth understanding and
effective interventions.
First, it is needed to shed a wide glance towards the
complexity of the experience. Among teenagers they
occur more and more regularly conduct problems and
externalization disorders: prostitution, misuse of drugs
or alcohol, depression, self-damaging or lifethreatening
acts. Also hetero-aggressive behaviours
like bullying (including cyber-bullying ,group violence,
including sexual one, until the domestic violence, are
frequent in the last few decades . The new addictions,
ranging from internet dependence until to online
gambling are not less insidious phenomena. A
particular focus is needed on eating disorders (anorexia,
bulimia and binge eating disorder) which mean an
increasingly common mode for the expression of
psychological and relational problems. They represent
different challenges for contemporary society since
they are the leading cause of death for psychiatric
disorders among adolescents, show peculiar forms of
resistance to treatment , and require an extremely
specialized and complex multidisciplinary treatment
approach .
In addition it must be observe that the adolescence
disorders represent very insidious threats also because
they produce vicious circles with serious consequences
for youth life, both as regards their psychopathology and
for their evolution into adulthood. About 36% of boys
and 32% girls have been bullied, while 40% of boys and
28% of girls were authors of bullying at least twice a
month. Bullying is linked to abnormalities in personality
development, to syndromes such as ADHD, to issues of
affective-relational development , and it can be a cause
of suicide . On the other hand, the decreasing of sleep
caused by internet addiction, cybersex, substance abuse
or alcohol can cause deterioration of social relations,
conduct disorders, anxiety disorders or major depression,
increasing also the suicidal ideation . Last but not least,
the research broadly supports the association between the
abuse of cannabis or other "minor" drugs and the
development of psychotic disorders such
as schizophrenia . While emotional and relational stress
in adolescence may cause an increase in BMI which is
related to the development of obesity in adulthood
The family is in crisis in the management of problems of
adolescents and sometimes it is the bearer of
psychopathology through physical or psychological
abuse, neglect and parenting inability. The attachment
and parenting dynamics, in particular, have been recently
sustained as possible common risk factors for any mental
disorder in general and for eating disorders and obesity
in particular . Depressive disorders and other psychiatric
disorders in parents can influence adaptation issues or
the adolescents’ psychopathology . The specific lack in
parenting skills is linked to disorders of somatization ,
eating disorders and borderline personality . On the other
hand it has been ascertained that conflicts and intrafamily
stress predispose to disorders such as substance
abuse in adolescents . The internet addiction has also
been correlated with disabilities in the intra-family
relationship and communication . Fredlund etc. point out
how prostituted teenagers have a deprived relationship
with parents during childhood. In turn prostitution or
other risky behaviours can lead to medical problems
(e.g., HIV infection) that require a significant
psychological and psychiatric care.
Extended Abstracts Vol 4, Iss1
This work is partly presented at 3rd International Conference and Exhibition on Neurology&Therapeutics September
08-10,2014 Philadelphia,USA Volume 4• Issue 1
On the other hand, as a remark for potential fields of
intervention, Johnson etc have pointed out that
adequate parenting behaviours are influential on the
resilience of the children, allowing better stress
management and a better emotional, affective and
relational adjustment in adulthood, regardless of
psychiatric disturbances in parents.
Substantial evidence is that psychiatric care during
adolescence is a crucial problem. Because of the
difficulties of families in managing the
psychopathology of children, the cases of teenagers
hospitalized in psychiatric wards for adults are
growing. This is aided by the increasingly early
physical and sexual development of youths, compared
with a delayed psychological maturity. This decoupling
makes very complex the management of behavioural
disorders. Despite the existence of effective therapies
for depression or bipolar disorder the use of coercive
means (admissions SPDC regime in TSO) is
increasingly frequently because of the impotence of the
family. The parents are often thwarted to build and
manage a relationship with their children also because
personal problems. They are often unable to establish
relations of authority and hierarchy to contain the
young on the affective and regulatory side of the
parenting relationship.
Also the public health services display critical
problems. Adolescents who undergo an inadequate
transition between the neuropsychiatric services and
those of adult psychiatry are numerous, many escape
from treatment and this often weighs heavily on the
outcome of their disorder .In some countries with an
advanced public health system they were applied
specific projects for prevention and early intervention
to stop the evolution in adulthood .The family
interventions are extremely important in order to reduce
untoward outcomes. Some encouraging evidences
emphasize that they represent a real possibility of
preventing psychological distress in adulthood with
obvious economic and social benefits.
Finally, a particular emphasis must be given to the need
for proper training of family doctors and pediatrists for
diagnose and treat neuropsychiatric problems in
adolescence, to the management of relational intrafamily
problems, and for offering support for parenting
.In fact, early and appropriate medical interventions are
necessary and may be effective for the proper
administration and prevention of the serious
consequences that the youth psychopathology can
generate in terms of rising mental support and costs for
healthcare systems.
Keywords: Adolescence; Psychopathology; Bullying;
Dependences; Family; Healthcare system