The most common mental illnesses manifesting at this time are schizophrenia, anorexia, and bulimia; schizoaffective disorder may also appear. Late adolescence is a time when symptoms of schizophrenic illness may appear, but one of the difficulties for the psychiatrist is that its symptoms are not the same as in the older adult; this may lead to psychotic symptoms being missed or being over-diagnosed. Schizophrenic illness may manifest in the following ways: withdrawal, increased anxiety, paranoid behaviour, violence, problems with the law, drug abuse, academic failure, strange behaviour, aggression, unrestrained promiscuity, particularly in girls, and any marked change in behaviour. An adolescent with an incipient psychotic illness may present a confusing picture to parents and professionals; this can lead to a series of consultations with a variety of professionals and a fragmentation of care. There may be resistance on the part of parents and professionals to recognise a psychotic illness in an adolescent, alongside the adolescent’s own fears and withdrawal.