oa Editorial: Adolescent Psychiatry Goes Global

This issue features articles based on presentations at the 2011 Congress of the International Society for Adolescent Psychiatry and Psychology, held in Berlin September 14-18. The theme of the congress was Adolescence: A Second Chance? Ably organized by an international scientific committee headed by Annette Streeck-Fischer and Franz Resch, the program spanned the entire field of adolescent psychiatry, and included presentations on developmental psychology, neurobiology, psychoanalysis, social and cultural aspects of adolescence, and new research. Nearly 600 attendees from around the globe participated. The program included symposia, state of the art lectures, and posters. This issue of Adolescent Psychiatry features articles from many of the leading presenters at the meeting, as well as selected abstracts that summarize many of the other presentations, and describe new research. The overall theme reflected the consensus among those who work with adolescents is that adolescence is indeed a second chance, but one that is often missed because of insufficient attention on the part of societies to the needs of adolescents. Many young people enter this often tumultuous period already compromised in their development because of adversity experienced earlier in their lives. Some of them experience further adversity during their teenage years, in part because of their pre-existing vulnerabilities. It was clear from the many leaders in adolescent psychiatry from around the world that youth everywhere are facing major challenges, whether they live in the richest nations or the poorest. Many of the presentations focused on the need to look beyond symptoms and nomenclature to underlying psychological dysfunctions-difficulties with relationships, with attachment, with mentalization, with affect regulation, and with self-image- in order to understand and effectively intervene with troubled adolescents. Others described collaborative efforts involving multiple centers and across countries to study such challenging conditions as borderline psychopathology. Borderline personality disorder and eating disorders were the two most common topics in the program, reflecting the concern over the high morbidity and mortality associated with these disorders. ISAPP (www.ISAAP.org) was established in 1984 as an international professional society to fill a void in the mental health arena. It is the only multi-disciplinary international organization devoted solely to the mental health needs of adolescents. Initially it represented a collaboration between American and European (mainly French) psychiatrists. Now it includes psychologists and other mental health professionals and counts members from Europe, Africa, and Asia as well as North and South America. Meetings are only held once every four years, however, many ISAPP members are involved in many other organizations (such as ASAP) and thus see each other at other meetings. In addition, the Internet has greatly facilitated communication. In this global age, it is increasingly important that we collaborate and learn from each other. This issue of Adolescent Psychiatry is dedicated to that end. While we in the United States struggle with limits imposed on treatment by third party payers, other countries struggle with a scarcity of mental health professionals and a lack of organized mental health services. Countries in Western Europe struggle to provide help to immigrant families who have poured in from poorer countries. Nearly all countries are facing record levels of youth unemployment, and some have seen violent protests by youth who complain that their future has been stolen. Inability of youth to become emancipated adults in the developed as well as the developing world have made future prospects for many of our adolescents bleak, and undoubtedly will have long term effects on mental health, families and societies. All countries seem to be facing rapid societal changes that have challenged the traditional role of the family. With all these confusing and discouraging developments, it is encouraging to know that there are people carrying out innovative treatment programs, doing research and teaching others how to work with adolescents. This issue begins with a succinct and accessible overview of the psychoanalytic perspective on adolescence by Werner Bohleber, a leading psychoanalyst in Germany. Dr. Bohleber recalls Freud's revolutionary discovery of infantile sexuality, which had the effect of demoting puberty, heretofore considered as giving birth to sexuality. He goes on to summarize the contributions of Anna Freud, ego psychology, feminist psychoanalysts, self-psychology, attachment theorists, and others and in the end, points to the need not to lose sight of the importance of the adaptation to the sexually mature body as well as the cognitive aspects of adolescent development. He points out that it is not possible to synthesize all of these elements into a coherent system, but rather that each offers a perspective that explains important aspects of adolescence. Following this article is the welcoming address given by then ISAPP President-Elect (now President) Annette Streeck Fisher of Germany, Adam and Eve-The Story of Two Adolescents. Dr. Streeck-Fischer points out that the Biblical myth of Adam and Eve can be viewed as a story of adolescent development.....