According to the Center for Disease Control (CDC), 3.2% of children aged 3-17 years have been diagnosed with depression. Many genetic conditions predispose children and adolescents to various mental health problems. Turner syndrome is a common sporadic genetic condition in females with medical issues, developmental delays, and psychiatric comorbidities. There is limited literature about adolescents with a late diagnosis of Turner syndrome and struggles with affective psychopathology. The early recognition and understanding of its unique genetics, neurobiology, and specific clinical manifestations are critical for addressing the needs of these patients.

The delusional misidentification syndromes (DMS) have been described extensively in the descriptive literature of the last century given its unusual and often-distressing clinical presentations. In the last few decades, there have been advances in scientific research that have identified more precise brain areas involved in these delusional syndromes. Since DMS are reported in both early-onset psychosis and neurodegenerative conditions, the strategies to address and mitigate underlying etiology warrant a thorough assessment and individualized treatment planning. The age of onset, nature of the clinical presentation, the utility of diagnostic tests, and assessment of violence are few among many areas which need attention during clinical management of these rare syndromes.

Borderline personality disorder (BPD) has seen significant advances in the knowledge of its developmental phenomenology during late childhood and adolescence. Various genetic, neurobiological, psychological, and social factors are implicated in the etiology of BPD. With emerging evidence on BPD development in adolescence, the review focused on recent literature to understand the role of psychosocial risk factors. The effects of adverse familial environment, physical, emotional, verbal, and sexual abuse, intergenerational transmission of psychopathological traits, maternal neglect and rejection, low socioeconomic status, bullying victimization, and dating violence were reviewed to understand their role in the development of BPD. BPD is a highly complex, serious, and enduring mental illness that has now been widely accepted to have symptoms that onset in early adolescence and could be diagnosed as early as age 12. BPD symptoms are stable, phenomenologically distinct from externalizing and internalizing disorders, and often present with co-occurring disorders, which during assessment could not explain impairments associated with BPD. New measures like the Difficulties in Emotion Regulation Scale (DERS), detailed developmental histories, understanding of psychosocial risks, shared decision-making, and psychoeducation could assist in early diagnosis and improvement of long-term outcomes. The implementation of evidence-based treatments is a challenge given higher costs and access to services; therefore, modifications in the treatment based on the core principles of these strategies should be considered. It is imperative to screen for psychosocial factors early in higher-risk groups. The assessment of familial factors, parental histories of psychopathologies, and histories of childhood abuse is important in context with impairing symptoms of clinical presentation and dimensional aspects of self-functioning. The role of family therapies, parental psychoeducation, and the integration of trauma-informed care approaches are important for clinical outcomes. Also, coordinated efforts with multiple stakeholders like school awareness programs, anti-bullying policies, legislation, and enforcement of existing laws might be instrumental in addressing issues related to victimization by peers.