Why do many psychiatric disorders emerge during adolescence?
Open accessAbstract
The peak age of onset for many psychiatric disorders is adolescence, a time of remarkable physical and behavioural changes. The processes in the brain that underlie these behavioural changes have been the subject of recent investigations. What do we know about the maturation of the human brain during adolescence? Do structural changes in the cerebral cortex reflect synaptic pruning? Are increases in white-matter volume driven by myelination? Is the adolescent brain more or less sensitive to reward? Finding answers to these questions might enable us to further our understanding of mental health during adolescence.
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Adolescence is associated with increased risk taking, accidents, and susceptibility to psychopathology.
“this developmental period is also associated with increased risk taking, accidents, and susceptibility to psychopathology (Crone et al., 2016; Giedd et al., 2008; Kessler, Berglund, et al., 2005; Steinberg, 2007).”
From Atypical interoception as a common risk factor for psychopathology: A review (2021) · cites this paper as Giedd et al., 2008
The Substance Abuse section says adolescents exhibit increased risk taking, and the Introduction and Relationship to psychopathology in adolescence sections describe adolescence as a period when several psychiatric disorders commonly emerge. The passages do not address an increased incidence of accidents; a search for “accident” found no supporting passage. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredReductions in gray matter volume might reflect synaptic reorganization and/or increases in white matter integrity.
“Despite these limitations, it is thought that reductions in gray matter volume might reflect synaptic reorganization and/or increases in white matter integrity (Paus et al. 2008).”
From Is Adolescence a Sensitive Period for Sociocultural Processing? (2014) · cites this paper as Paus et al. 2008
The “Adolescence = pruning + myelination?” section suggests that reduced synapses could indirectly reduce cortical grey-matter volume and that increased myelination of intra-cortical axons could produce an apparent loss of grey matter. It does not specifically attribute the reduction to increased white-matter integrity, and it cautions that MRI findings cannot be assigned to a single biological process. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAdolescence is a period of increased vulnerability to anxiety or depressive symptoms.
“Further, adolescence is a time of increased vulnerability to develop anxiety or depressive symptoms (Paus et al., 2008)”
From Effects of traumatic experiences on obsessive-compulsive and internalizing symptoms: The role of avoidance and mindfulness. (2018) · cites this paper as Paus et al., 2008
Adolescents are vulnerable to mental health problems.
“Faced with this cocktail of stressful new experiences on a background of unstable hormones and altered brain function, it is perhaps unsurprising that adolescents are vulnerable to mental health problems (Kessler et al., 2005;Lee et al., 2014;Paus et al., 2008).”
From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Paus et al., 2008
White matter volume steadily increases from childhood into adolescence, accompanied by changes in DWI parameters, suggesting maturation of axons/myelin sheaths represents an ongoing developmental process.
“Magnetic Resonance Imaging (MRI) studies in humans have shown that white matter volume steadily increases from childhood into adolescence, accompanied by changes in Diffusion Weighted Imaging (DWI) parameters, suggesting that maturation of axons/myelin sheaths represents an ongoing (developmental) process (Paus et al., 2008).”
From Acceptance and Commitment Therapy and white matter plasticity in individuals with subclinical depression and psychotic experiences: A Randomised Controlled Trial (2023) · cites this paper as Paus et al., 2008
Early abnormalities of maturational changes appear from the ectodermal phase to the first year after birth (first-wave hits).
“Early abnormalities of maturational changes appear from the ectodermal phase to the first year after birth (first-wave hits) 49 .”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [49]
Depression usually appears in adolescence rather than earlier, despite early environmental adversity, in both human and animal models of early-life stress.
“Depression typically does not emerge until the adolescent period despite early environmental insults, and this relatively late onset of depression has been documented in both human and non-human animal models of ELS”
From Reduced nucleus accumbens reactivity and adolescent depression following early-life stress (2013) · cites this paper as Paus et al., 2008
Children, and especially adolescents, are susceptible to experiencing mental health problems.
“It has been well established in the literature that children, and especially adolescents, are susceptible to experiencing mental health problems, while most mental disorders have their onset in this age period [51,52].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [52]
Most mental disorders have their onset in childhood and adolescence.
“It has been well established in the literature that children, and especially adolescents, are susceptible to experiencing mental health problems, while most mental disorders have their onset in this age period [51,52].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [52]
Resolving inconsistencies in the developmental reward literature is important for understanding the neural correlates of risky behaviors and risk factors for psychopathology that emerge during adolescence.
“It is important to resolve these inconsistencies to gain a better understanding of the neural correlates of risky behaviors and risk factors for psychopathology that emerge during adolescence (Galvan, 2010; Paus et al., 2008).”
From A systematic review of fMRI reward paradigms used in studies of adolescents vs. adults: The impact of task design and implications for understanding neurodevelopment (2013) · cites this paper as Paus et al., 2008
Grey matter decline may reflect an artefact of increased myelination of intra-cortical axons rather than synaptic pruning.
“Instead, grey matter decline may reflect an artefact of increased myelination of intra-cortical axons (Bourgeois and Rakic, 1993, Paus, 2005, Paus et al., 2008).”
From Neurocognitive bases of emotion regulation development in adolescence (2015) · cites this paper as Paus et al., 2008
Adolescence is a period of increased emotional reactivity and psychopathology.
“Adolescence is a period of increased emotional reactivity and psychopathology.”
From Neurocognitive bases of emotion regulation development in adolescence (2015) · cites this paper as Paus et al., 2008
Structural brain development in regions subserving emotion regulation continues into adulthood.
“Evidence suggests that structural brain development in brain regions subserving emotion regulation continues into adulthood (Paus et al., 2008).”
From Neurocognitive bases of emotion regulation development in adolescence (2015) · cites this paper as Paus et al., 2008
Psychopathology associated with internalising symptoms notably increases during the adolescent years.
“Psychopathology associated with internalising symptoms notably increases during the adolescent years (Lee et al., 2014, Paus et al., 2008).”
From Neurocognitive bases of emotion regulation development in adolescence (2015) · cites this paper as Paus et al., 2008
The onset of many psychiatric conditions occurs during adolescence.
“Given that the onset of many psychiatric conditions occurs during adolescence (72), and that genotype variations have been associated with the incidence of developmental psychiatric disorders, elucidating the role of genetics in determining brain function during childhood and adolescence is critical to our understanding of the development of these disorders.”
From Influence of the COMT genotype on working memory and brain activity changes during development (2011) · cites this paper as [72]
Adolescence (P21) to adulthood (P60) in mouse is a critical postnatal period believed to be associated with greatly increased neuroplasticity and manifestation of most neuropsychiatric disorders.
“We then analyzed transcriptional dynamics in each of the neuron subtypes between adolescence8,9 (P21) and adulthood (P60) in mouse, a critical postnatal period believed to be associated with greatly increased neuroplasticity, and manifestation of most neuropsychiatric disorders7,10.”
From Cell type-specific transcriptional programs in mouse prefrontal cortex during adolescence and addiction (2019) · cites this paper as [10]
Transcriptional plasticity during adolescence is believed to play a key role in disease pathogenesis.
“transcriptional plasticity during this period is believed to play a key role in disease pathogenesis10.”
From Cell type-specific transcriptional programs in mouse prefrontal cortex during adolescence and addiction (2019) · cites this paper as [10]
Initial manifestation of these disorders frequently occurs during adolescence.
“Since initial manifestation of these disorders frequently occur during adolescence”
From Cell type-specific transcriptional programs in mouse prefrontal cortex during adolescence and addiction (2019) · cites this paper as [10]
Many psychiatric disorders associated with genetic defects surface during adolescence.
“Many psychiatric disorders associated with genetic defects surface during adolescence10.”
From Cell type-specific transcriptional programs in mouse prefrontal cortex during adolescence and addiction (2019) · cites this paper as [10]
A potential imbalance between the time courses of cortical and subcortical neural circuitry development is one hypothesized mechanism of adolescent vulnerability to disorders such as SAD.
“A potential imbalance between the time courses of cortical and subcortical neural circuitry development is one hypothesized mechanism of adolescent vulnerability to disorders such as SAD (Paus et al., 2008).”
From Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience (2014) · cites this paper as Paus et al., 2008
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- Authors
- Paus, T., Keshavan, M., & Giedd, J. N.
- Affiliations
- Montreal Neurological Institute and Hospital (CA)
- Beth Israel Deaconess Medical Center (US)
- National Institute of Mental Health (US)
- Corresponding author
- Paus, Tomáš
- Giedd, Jay N.
- Venue
- Nature Reviews Neuroscience
- Published
- 2008-11-12
- Volume
- 9
- Issue
- 12
- Pages
- 947-957
- ISSN
- 1471-003X (ISSN-L)
- 1471-0048
- PMC
- PMC2762785
- OpenAlex
- W2040073285
- Semantic Scholar
- 7c469b7f89043f4867b02938be67d786fc761827
- Cited by
- 3,123
- References
- 117
- Citations by year
- 2026: 198 · 2025: 230 · 2024: 213 · 2023: 242 · 2022: 230 · 2021: 262 · 2020: 251 · 2019: 162 · 2018: 202 · 2017: 147 · 2016: 179 · 2015: 186 · 2014: 148 · 2013: 149 · 2012: 100
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature reviews. Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (Z01MH002794)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Keywords
- adolescent brain development, mental illness, synaptic pruning, cortical maturation, white matter myelination, reward sensitivity
- MeSH terms
- Adolescent, Mental Disorders, Brain, Humans, Synaptic Transmission, Peer Group, Sex Characteristics, Age of Onset, Adolescent Development
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