Introduction

Gender differences in the prevalence of mood disorders have been well documented. Prior to adolescence, the rate of depression is more or less similar in girls and boys; yet, with the onset of puberty, there is an associated increase in prevalance of depression as well as other psychiatric disorders in girls (Figure 3.1). Puberty is also a period of social and sexual tension; these can be the precipitating factors for the development of psychological disorders such as eating disorders, anxiety, panic attacks, substance and alcohol misuse.

It is not known what proportion of the psychological change around puberty and the subsequent teens is the direct consequence of adolescence itself as opposed to the direct psychoneuroendocrine effects of previously unfamiliar cyclical hormone changes. There are many changes occurring at this period of life. It would be naïve to attribute all of the psychological changes at puberty to a single hormonal, genetic, environmental, familial or psychosocial factor and all of these must be considered.

Puberty

Puberty is the period of time during which secondary sexual characteristics are being developed. Menstruation begins and the psychosexual outlook of girls changes. The most important fact about pubertal changes is that it varies in the age of onset, time of development and order of appearance. The average age of menarche in the UK is 13 years and 95% of the population will reach it between the ages of 11 years and 15 years.