Adolescence is a transitional period of life, both biologically and psychologically. Still the psychiatric approach to this life phase was neglected until recently, because many symptoms were regarded as normal, acceptable expressions of unavoidable internal turbulence during a highly critical period of development. Adolescence presents unique problems with strong biological impulses pushing at puberty, followed by separation and individuation processes which mark the entrance of the youngster to adult society. One psychiatrist referred to this life period as a time of 'normal psychosis', stating that the label 'normal adolescence' was a contradiction in terms.

This complacent attitude changed in the last decade due to the realization that excessive drug abuse, widespread youth rebellions, and other symptoms of alienation in some cases resulted in serious disabilities extending into adult life. Other researchers have been less pessimistic. For example, Offer et al. have considered adolescence much less disturbed emotionally than previous studies indicated, and suggested that only a small percentage of youngsters demonstrated real psychiatric symptoms. They felt the heightened tendency to challenge authority in early adolescence steadily diminished and only rarely resulted in destructive or illegal activity.

Adolescent psychiatry has become an independent subspeciality beset by methodological difficulties. Its nosology is even more confused than psychiatric labeling or diagnosis. The psychological instability, the impulsive tendency to act on emotions and the difficulty of adolescents in sincerely reporting their problems to an adult are some of the more important obstacles which hinder necessary categorization. The same difficulties are even more challenging when dealing with problems originating from psycho-sexual developments. Most adolescents are at best reluctant when referred to psychiatric treatment. Referral by others often leads to a sense of loss of autonomy and independent choice; in addition, most adolescents have an increased narcissistic vulnerability which makes the formation of a mature therapeutic relationship difficult.