Adolescents are in a stage of contrast and ambivalence. The quick mood changes accentuate this seemingly irresponsible, irrational and inconsistent time of life.
Chronic somatic diseases add new stress to the puberty period of these adolescents. Chronic somatic diseases are particularly problematic in the interference of the adolescent´s achievement of greater personal independence. Acceptance by a peer group and development of an intimate sexual relationship become critical. Many adolescents with chronic diseases are especially vulnerable to feelings of defectiveness or weakness in comparison to their contemporaries. Chronic diseases, which result in problems with physical appearance, most often show disturbances in emotional adaptation. The goal of treating adolescents with chronic diseases is thus not only to treat physical health but also mental health. An effective management of chronic diseases in children and adolescents requires multidisciplinary team consisting of a pediatrician, pediatric nurses, play therapists, teachers, social workers, psychologists and child psychiatrist. Juvenile-onset diabetes mellitus is seen to be good model for a chronic somatic disorder in adolescents. These diabetics must maintain a delicate balance among daily insulin requirements, exercise and diet just to survive and function normally. To maintain this balance, they are taught to give blood tests several times a day, inject insulin several times a day, adhere to restrictive dietary requirements and pay attention to exercise and activity. Diabetes presents a great challenge not only to diabetic adolescents, but also to their parents and siblings. Multidisciplinary teams for diabetics and their families must remain diligent, open-minded and optimistic to promote the best possible health for the adolescents who live with the daily challenge of chronic somatic diseases.
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