The most important task for the psychiatrist examining a troubled adolescent is to assess accurately the severity of the psychopathology, differentiating in the process emotional turmoil as part of a neurosis or an adjustment reaction, from early manifestations of psychosis or severe character pathology. Varying degrees of anxiety and depression, emotional outbursts and temper tantrums, excessive rebelliousness or dependency, sexual inhibition, and polymorphous perverse sexual impulses and behaviors may present in adolescents without severe character pathology as well as in psychotic youngsters and in those with very severe characterological disturbances.