 Half of all mental health disorders in adulthood start by age 14, but most

cases are undetected and untreated.

Around 1.2 billion people, or 1 in 6 of the world’s population, are adolescents aged 10 to
19.

Most are healthy, but there is still substantial premature death, illness, and injury among
adolescents. Illnesses can hinder their ability to grow and develop to their full potential.
Alcohol or tobacco use, lack of physical activity, unprotected sex and/or exposure to
violence can jeopardize not only their current health, but also their health as adults, and
even the health of their future children.

Promoting healthy behaviours during adolescence, and taking steps to better protect
young people from health risks are critical for the prevention of health problems in
adulthood, and for countries’ future health and ability to develop and thrive.

Main health issues include:

Early pregnancy and childbirth
The leading cause of death for 15– 19-year-old girls globally is complications from
pregnancy and childbirth.

Some 11% of all births worldwide are to girls aged 15–19 years, and the vast majority of
these births are in low- and middle-income countries. The UN Population Division puts
the global adolescent birth rate in 2015 at 44 births per 1000 girls this age – country
rates range from 1 to over 200 births per 1000 girls (1). This indicates a marked
decrease since 1990. This decrease is reflected in a similar decline in maternal mortality
rates among 15–19 year olds.

One of the specific targets of the health Sustainable Development Goal (SDG 3) is that
by 2030, the world should ensure universal access to sexual and reproductive health-
care services, including for family planning, information and education, and the
integration of reproductive health into national strategies and programmes. To support
this, a proposed indicator for the Global strategy for women’s, children’s and
adolescents’ health is the adolescent birth rate.

Better access to contraceptive information and services can reduce the number of girls
becoming pregnant and giving birth at too young an age. Laws that specify a minimum
age of marriage at 18 and which are enforced can help.

Girls who do become pregnant need access to quality antenatal care. Where permitted
by law, adolescents who opt to terminate their pregnancies should have access to safe
abortion.
HIV
More than 2 million adolescents are living with HIV. Although the overall number of HIV-
related deaths is down 30% since the peak in 2006 estimates suggest that HIV deaths
among adolescents are rising. This increase, which has been predominantly in the
WHO African Region, may reflect the fact that although more children with HIV survive
into adolescence, they do not all then get the care and support they need to remain in
good health and prevent transmission. In sub-Saharan Africa only 10% of young men
and 15% of young women aged 15 to 24 are aware of their HIV status.

One of the specific targets of the health Sustainable Development Goal (SDG 3) is that
by 2030 there should be an end to the epidemics of AIDS, tuberculosis, malaria and
neglected tropical diseases, hepatitis, water-borne diseases and other communicable
diseases. Given the high prevalence of HIV in many countries, to achieve this,
adolescents will need to be central to control efforts.

Young people need to know how to protect themselves and must have the means to do
so. This includes being able to obtain condoms to prevent sexual transmission of the
virus and clean needles and syringes for those who inject drugs. Better access to HIV
testing and counselling, and stronger subsequent links to HIV treatment services for
those who test HIV positive, are also needed.

Other infectious diseases

Thanks to improved childhood vaccination, adolescent deaths and disability from
measles have fallen markedly – for example, by 90% in the African Region between
2000 and 2012. Diarrhoea and lower respiratory tract infections are estimated to be
among the top 5 causes of death for 10–19 year olds. These two diseases, together
with meningitis, are the top three causes of adolescent death in African low and middle-
income countries (LMICs).

Mental health
Depression is the third leading cause of illness and disability among adolescents, and
suicide is the third leading cause of death in older adolescents (15–19 years). Violence,
poverty, humiliation and feeling devalued can increase the risk of developing mental
health problems.

Building life skills in children and adolescents and providing them with psychosocial
support in schools and other community settings can help promote good mental health.
Programmes to help strengthen the ties between adolescents and their families are also
important. If problems arise, they should be detected and managed by competent and
caring health workers.
Violence
Violence is a leading cause of death in older adolescent males. Interpersonal violence
represents 43% of all adolescent male deaths in LMICs in the WHO Americas Region.
Globally, 1 in 10 girls under the age of 20 years report experiencing sexual violence.

Promoting nurturing relationships between parents and children early in life, providing
training in life skills, and reducing access to alcohol and firearms can help to prevent
injuries and deaths due to violence. Effective and empathetic care for adolescent
survivors of violence and ongoing support can help deal with the physical and
psychological consequences.

Alcohol and drugs

Harmful drinking among adolescents is a major concern in many countries. It reduces
self-control and increases risky behaviours, such as unsafe sex or dangerous driving. It
is a primary cause of injuries (including those due to road traffic accidents), violence
(especially by a partner) and premature deaths. It can also lead to health problems in
later life and affect life expectancy. Setting a minimum age for buying and consuming
alcohol and regulating how alcoholic drinks are targeted at the younger market are
among the strategies for reducing harmful drinking.

Drug use among 15–19 year olds is also an important global concern. Drug control may
focus on reducing drug demand, drug supply, or both, and successful programmes
usually include structural, community, and individual-level interventions.

Injuries
Unintentional injuries are the leading cause of death and disability among adolescents.
In 2015, over 115 000 adolescents died as a result of road traffic accidents. Young
drivers need advice on driving safely, while laws that prohibit driving under the influence
of alcohol and drugs need to be strictly enforced. Blood alcohol levels need to be set
lower for teenage drivers. Graduated licences for novice drivers with zero-tolerance for
drink-driving are recommended.

Drowning is also a major cause of death among adolescents – 57 000 adolescents, two-
thirds of them boys, are estimated to have drowned in 2015, and teaching children and
adolescents to swim is an essential intervention to prevent these deaths.

Malnutrition and obesity

Many boys and girls in developing countries enter adolescence undernourished, making
them more vulnerable to disease and early death. At the other end of the spectrum, the
number of adolescents who are overweight or obese is increasing in low, middle and
high-income countries.

Exercise and nutrition

Iron deficiency anaemia is the leading cause of years lost to death and disability in
2015. Iron and folic acid supplements are a solution that also helps to promote health
before adolescents become parents. Regular deworming in areas where intestinal
helminths such as hookworm are common is recommended to prevent micronutrient
(including iron) deficiencies.

Developing healthy eating and exercise habits in adolescence are foundations for good
health in adulthood. Reducing the marketing of foods high in saturated fats, trans-fatty
acids, free sugars, or salt and providing access to healthy foods and opportunities to
engage in physical activity are important for all but especially children and adolescents.
Yet available survey data indicate that fewer than 1 in every 4 adolescents meets the
recommended guidelines for physical activity: 60 minutes of moderate to vigorous
physical activity daily.

Tobacco use
The vast majority of people using tobacco today began doing so when they were
adolescents. Prohibiting the sale of tobacco products to minors and increasing the price
of tobacco products through higher taxes, banning tobacco advertising and ensuring
smoke-free environments are crucial. Globally, at least 1 in 10 adolescents aged 13 to
15 years uses tobacco, although there are areas where this figure is much higher.
Cigarette smoking seems to be decreasing among younger adolescents in some high-
income countries.

Rights of adolescents
The rights of children (people under 18 years of age) to survive, grow and develop are
enshrined in international legal documents. In 2013, the Committee on the Rights of the
Child (CRC), which oversees the child rights convention, published guidelines on the
right of children and adolescents to the enjoyment of the highest attainable standard of
health, and a General Comment on realizing the rights of children during adolescence
was published in 2016. It highlights states’ obligations to recognise the special health
and development needs and rights of adolescents and young people.

The Convention on the Elimination of Discrimination Against Women (CEDAW) also

sets out the rights of women and girls to health and adequate health care.
WHO response
In May 2017, WHO published a major report: Global Accelerated Action for the Health
of Adolescents (AA-HA!): Guidance to support country implementation. The AA-HA!
Guidance has drawn on inputs received during extensive consultations with Member
States, United Nations agencies, adolescents and young people, civil society and other
partners. It aims to assist governments in deciding what they plan to do and how they
plan to do it as they respond to the health needs of adolescents in their countries. This
reference document targets national-level policy-makers and programme managers to
assist them in planning, implementing , monitoring and evaluation of adolescent health
programmes.

Overall, WHO carries out a range of functions to improve the health of young people,
including:

 production of evidence-based guidelines to support health services and other

sectors;
 making recommendations to governments on adolescent health and the
provision of high quality, age-appropriate health services for adolescents;
 documenting progress in adolescent health and development; and
 raising awareness of health issues for young people among the general public
and other interested stakeholders.

References
(1) SDG Indicators, Global Database
https://unstats.un.org/sdgs/indicators/database/?indicator=3.7.2

http://www.who.int/en/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions

WHO BOOK

http://apps.who.int/iris/bitstream/handle/10665/259628/WHO-MCA-17.09-
eng.pdf;jsessionid=9ECA850574D024167F5DC9C42504A1A1?sequence=1

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Attention-Deficit / Hyperactivity Disorder (ADHD)

 Articles

Is it ADHD?
Language:

English (US)

 Español (Spanish)

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Learn about the symptoms of ADHD and what to do if you’re concerned that your child might
have this disorder.

Attention-Deficit / Hyperactivity Disorder (ADHD) is one of the most

common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often
lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive
behaviors (may act without thinking about what the result will be), and in some cases, are overly
active.

Signs and Symptoms

It is normal for children to have trouble focusing and behaving at one time or another. However,
children with ADHD do not just grow out of these behaviors. The symptoms continue and can cause
difficulty at school, at home, or with friends.

A child with ADHD might:

 have a hard time paying attention

 daydream a lot
 not seem to listen
 be easily distracted from schoolwork or play
 forget things
 be in constant motion or unable to stay seated
 squirm or fidget
 talk too much
 not be able to play quietly
 act and speak without thinking
 have trouble taking turns
 interrupt others

Diagnosis
Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose
ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of
learning disabilities, can have similar symptoms. One step of the process involves having a medical
exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD.
Another part of the process may include a checklist for rating ADHD symptoms and taking a history
of the child from parents, teachers, and sometimes, the child.

Get Help!

Is it ADHD? Symptoms Checklist

Fill out the symptoms checklist and share it with the child’s doctor or download and print.
If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a
child psychologist or developmental pediatrician, or you can contact your local early intervention
agency (for children under 3) or public school (for children 3 and older).
To find help in your area, look for the closest Parent Center.
The Centers for Disease Control and Prevention (CDC) sponsors the National Resource Center on
ADHD: A Program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder.
Their web site has links to information for people with ADHD and their families. The National
Resource Center on ADHD operates a call center with trained staff to answer questions about
ADHD. The number is 1-800-233-4050.
In order to make sure your child reaches his or her full potential, it is very important to get help for
ADHD as early as possible.

Attention-deficit/hyperactivity disorder
Also called: ADHD, attention deficit disorder
ABOUT

SYMPTOMS

TREATMENTS

Requires a medical diagnosis

Symptoms include limited attention and hyperactivity.

People may experience:

Behavioural: aggression, excitability, fidgeting, hyperactivity, impulsivity, irritability, lack of

restraint, or persistent repetition of words or actions

Cognitive: absent-mindedness, difficulty focusing, forgetfulness, problem paying attention, or

short attention span

Mood: anger, anxiety, boredom, excitement, or mood swings

Also common: depression or learning disability

Consult a doctor for medical advice

Treatment consists of therapy

Treatments include medication and talk therapy.

Therapies

Support group

A forum for counseling and sharing experiences among people with a similar condition or goal,
such as depression or weight loss.
Cognitive behavioral therapy

A talk therapy focused on modifying negative thoughts, behaviours and emotional responses
associated with psychological distress.

Anger management

Practicing mindfulness, coping mechanisms and trigger avoidance to minimise destructive

emotional outbursts.

Intervention

A branch of psychology that treats personal problems related to school, work, family and social
life.

Psychoeducation

Education about mental health that also serves to support, validate and empower patients.

Family therapy

Psychological counselling that helps families resolve conflicts and communicate more
effectively.

Applied behavior analysis

A teaching method that helps autistic children learn socially significant skills by encouraging
positive behaviour.

Medications

Stimulant

Increases neurotransmitter levels, heart rate and blood pressure. Decreases appetite and sleep.

Cognition-enhancing medication

Improves mental function, lowers blood pressure and may balance mood.

Antihypertensive drug

Lowers blood pressure.

pecialists

Clinical Psychologist

Treats mental disorders primarily with talk therapy.

Psychiatrist
Treats mental disorders primarily with medications.

Paediatrician

Provides medical care for infants, children and teenagers.

Primary Care Provider (PCP)

Prevents, diagnoses and treats diseases.

Sources: Apollo Hospitals and others. Learn more