Adolescence is a biopsychosocial construct that, by definition, cannot be limited by an age criterion—it's "a stage, not an age"! Adolescence can be described as a variable period between childhood and adulthood characterized by rapid development and change in the psychological, social, and biological domains. In any professional meeting where adolescent matters are discussed, the topic of age criteria for adolescence is rarely absent. However, there are as many definitions as there are adolescents (Table 1).
Although 19 years is frequently accepted as the upper age limit in the United Kingdom and the United States (3,4), other policy documents have considered this age group and found them wanting (6-8). A disproportionate prevalence of disadvantage is reported in the 16- to 25-year-old age group (7), the age band within which many of the transitions described above are likely to take place. Reassuringly, the definition of youth by both the European Union (5) and the World Health Organization (2) include the "invisible early twenties" (9). There have been recent calls from psychologists to recognize the early 20s as another stage of adolescent development—that of "emerging adulthood" —particularly in the light of the sociocultural shifts that serve to delay many of the normal adolescent transitions (8,9). This period of late adolescence and young adulthood is too often at risk of becoming a twilight zone, with young people falling out of pediatrics but not yet falling into adult medicine. When the impact of illness on adolescent development is then considered, age criteria become even more irrelevant, as developmental tasks are at risk, resulting in delay and/or limited achievement.
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