Clinicians are reluctant to diagnose severe mental disturbances in adolescents. The psychoanalytic literature on adolescent turmoil has de-emphasized the phenomenology of the clinical picture leading to diagnostic difficulties. Several studies have shown that symptomatic adolescents for the most part continue to demonstrate disturbances in adulthood. This paper reports on the population of adolescents admitted to an inpatient unit and compares it with a population admitted three years earlier. There was an increase in the number of referrals indicating a greater demand for service by the community. The patient population showed a significant trend toward more serious psychiatric disturbance, psychoses and personality disorders, with far fewer adjustment reactions. There was also a great increase in the number of re-admissions which again reflects severity of illness. Antidepressants continue to be infrequently used. Major tranquilizers were used less frequently and with greater specificity in both psychoses and personality disorders. Major implications for identifying and treating recurrent psychiatric illnesses in adolescents are discussed.
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