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Mental Health Disorders in Adolescents

Obstet Gynecol; ePub 2017 Jul; Brookman, et al

Obstetricians and gynecologists play a key role in the management of mental health disorders in adolescents through early identification, prompt referral, and care coordination, according to a recent American College of Obstetricians and Gynecologists (ACOG) committee opinion. The opinion provides basic information about common adolescent mental health disorders, focusing on specific implications for gynecologic and obstetric practice. It also offers the following ACOG recommendations and conclusions:

  • At least 1 in 5 youth aged 9–17 years currently has a diagnosable mental health disorder that causes some degree of impairment; 1 in 10 has a disorder that causes significant impairment.
  • The most common mental illnesses in adolescents are anxiety, mood, attention, and behavior disorders.
  • Suicide is the second leading cause of death in young people aged 15–24 years.
  • Obstetrician–gynecologists who see adolescent patients are highly likely to see adolescents and young women who have ≥1 mental health disorders.
  • Adolescents with mental illness often engage in acting-out behavior or substance use, which increase their risk of unsafe sexual behavior that may result in pregnancy or sexually transmitted infections (STIs).
  • Adolescents with psychiatric disorders may be taking psychopharmacologic agents that can cause menstrual dysfunction and galactorrhea.
  • Pregnant adolescents who take psychopharmacologic agents present a special challenge in balancing the potential risks of fetal harm with the risks of inadequate treatment.
  • During preventive care visits, all adolescents should be screened for any mental health disorder in a confidential setting.
  • The obstetrician–gynecologist has the opportunity to reduce morbidity and mortality associated with mental health disorders in adolescents by early identification, prompt referral, and care coordination.

Citation:

Mental health disorders in adolescents. Committee Opinion No. 705. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;130:e32–41.