Why does schizophrenia develop at late adolescence?

Schizophrenia is one of the most researched, yet still one of the least und erstood, of the mental disorders. One key area that remains comparatively n eglected is the fact that Schizophrenia typically develops at late adolesce nce. In common with people with psychotic disorders, around 25% of normal t eenagers also report finding adolescence very distressing, and a substantia l empirical literature shows that certain characteristics typical of adoles cence such as conflicted family relationships, grandiosity, egocentrism, an d magical ideation bear a distinct resemblance to phenomena seen in psychot ic disorders. Indeed, such phenomena, as might be judged prodromal or sympt omatic in first-onset schizophrenia, have been shown to be remarkably commo n in normal adolescents, generally in about 50% of samples. Furthermore, pr odromal-like signs in normal adolescents appear to be functionally linked t o psychological development. For most adolescents, such phenomena pass with successful psychological development. It is proposed that psychosis in lat e adolescence is a consequence of severe disruption in this normally diffic ult psychological maturational process in vulnerable individuals, and expla nations are offered as to why and how this comes about. It is suggested tha t problems either in reaching psychological maturity with regard to parents or in bonding to peers or both, may lead to crucial self-construction diff iculties, and that psychosis emerges out of such "blocked adolescence". Thi s approach proposes therapeutic interventions that enable professional serv ices to side with both parents and clients simultaneously, and is normalizi ng and stigma-free. (C) 2001 Elsevier Science Ltd.