Adolescence

Adolescence is a period beginning at about the age of 10 and continuing until the end of the senior school age or until age 21, during which children are exposed to significant physical, intellectual and emotional changes. Helping a child to go through this period is not an easy task for both parents and health professionals.

Fortunately, adolescents have good physical health, but psychosocial problems are widespread, so even normal individuals struggle with contradictions in their own individuality, autonomy, sexuality, interpersonal relationships. "Who am I, where am I going, how do I relate to all these people in my life?" - these are the main questions that occupy the minds of most adolescents. Many behavioral abnormalities that begin in the adolescent period (for example, smoking, drug use, violence) are possible causes of mortality at a later age.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]

Physical development of adolescents

All organs and systems, as well as the organism as a whole, undergo the greatest growth during the adolescent period; the most striking changes occur with the mammary glands in girls, the sexual organs and the hair in adolescents of both sexes. Even if this process proceeds normally, the child needs emotional support. If the timing is violated, especially in boys with late development or in girls with early, it is likely the development of additional emotional stress. Most boys who develop slowly have a constitutional delay and subsequently catch up with their peers. However, it is necessary to examine the child in order to exclude pathological causes.

Adolescents are required in the organization of rational nutrition, exercise, lifestyle, special attention should be paid to the importance of different activities such as sports, art, social activities, and the role of public services in the lives of individuals. The relative requirement of the organism for protein and calories (g or kcal / kg of body weight) progressively decreases from the end of the first year until the end of the adolescent period, while the absolute requirement increases. At the end of the adolescent period, the protein requirement is 0.9 g / (kg x day); the average energy requirement is 40 kcal / kg.

Sexuality of adolescents

In addition to adapting to the changes that occur in their bodies, adolescents must get used to the role of adult men and women and not to succumb to sexual attraction, which can be very strong. It is necessary to determine the attitude to yourself, as well as the relationship with the opposite sex; before some teenagers there is a question on sexual self-identification. Few elements of human experience combine physical, mental and emotional aspects as deeply as sexuality. It is extremely important to help a teenager in the healthy formation of sexuality, including issues of morality and the creation of a family.

Intellectual development of adolescents

When a teenager encounters more difficult tasks in school, he begins to determine for himself areas that are given to him easier, and which are harder. The weight of making decisions about the future career is increasing, and many teenagers do not have a clearly defined goal, although gradually they determine the spheres that they are interested in and in which they are talented. Parents and doctors should be aware of the opportunities of the teenager, should help him formulate realistic expectations and be ready to identify obstacles to learning that require correction, such as problems with learning, with attention, tense situation in the school.

Emotional development of adolescents

Emotional aspect is the most difficult, often challenging patience of parents, teachers and doctors. Emotional lability is very common, as is frustration, which appears due to attempts to develop immediately in many ways. The bulk of conflicts are developing because of the desire of a teenager to have more freedom, which is faced with the strongest instinct of parents to protect their child from trouble. Communication can be difficult even in stable families, and worsens if the parents are divorced or are themselves experiencing emotional problems. Doctors can greatly help by offering adolescents and their parents reasonable, real help and support in building relationships within the family.

[14], [15]

Medical problems in adolescence

Although adolescents suffer from the same illnesses as younger children, they are generally a healthy group. Adolescents should continue to be vaccinated according to the recommended schedule). Many at this age are concerned about youthful acne; This problem must be addressed, as it reduces self-esteem. Injuries are very common in the adolescent period, most often sports or car injuries. Violence, sometimes with the use of weapons, is a daily threat in certain groups of adolescents.

Obesity is one of the most common reasons for visiting adolescent clinics. Most cases of obesity are associated with excessive diet, often in combination with a sedentary lifestyle. Genetic predisposition is also common, and genes responsible for obesity have already been established. The definition of body mass index (BMI) is considered as an important aspect of assessing physical development. Primary endocrine (for example, hypercortisy, hypothyroidism) or metabolic causes of obesity are rare. Hypothyroidism as a cause should be excluded and can be assumed with a significant growth retardation. If the child has a small height and has hypertension, Cushing's syndrome should be assumed. Because of obesity, adolescents often have type 2 diabetes mellitus. Despite the large number of existing approaches, the treatment of obesity is one of the most difficult problems.

Infectious mononucleosis is especially characteristic for adolescence. An important problem are sexually transmitted diseases, the infection of the urinary system (IMS) is common in girls. Some endocrine disorders, especially thyroid pathology, are often found in adolescents, as well as menstrual dysfunction. Iron deficiency is relatively common in adolescent girls. Although infrequent, but also can occur oncological diseases, such as leukemia, lymphoma, tumors of the bones, the brain.

Psychosocial disorders in adolescence

Doctors should remember the high incidence of psychosocial disorders that occur during this difficult period of life. Depression is common, and it should be actively identified. Suicide and especially suicidal attempts are common. Anxiety disorder is often manifested in adolescence, as well as emotional lability. It is during adolescence that the debut of an existing mental illness can manifest itself. Violation of the attitude towards food, especially in girls, is common. Some patients go to extraordinary measures to hide anorexia or bulimia.

Problems in school, especially if they are associated with difficulties in learning a subject or problems with attention, can be resolved by a doctor who must work in close cooperation with school staff and parents. Changes in the environment, and sometimes medication, can significantly improve the situation of trying students.

The constant concern is the abuse of psychoactive substances, which represents a psychosocial problem. Extreme use of alcohol and smoking, followed by marijuana and other drugs.

A doctor who has managed to build an open, trusting relationship with a teenager can often identify these problems himself, can offer support and practical advice, and can also get a teenager's consent to a more in-depth examination, if necessary.