The records of four hundred and fifty four (454) adolescent comprising of two hundred and thirty nine (239) female and two hundred and fifteen (215) male who had attended a psychiatric out-patient clinic in Accra over a seven year period were reviewed. Only 269 patients had psychiatric illness while 185 (40.7%) had purely physical illness with no associated psychiatric illness. Of the 269 (59.3%) with psychiatric illness, there were 88 (32.7%) with functional psychoses consisting mainly of depression, 47 (17.5%), and psychoneurotic disorders 63, (23.4%); with personality disorders, 55 (20.4%) and with organic psychosis, 27, (10%) while 36, (13.4%) had psychiatric disorders. The aetiology of these disorders could be deduced from the profound biological events that occur during adolescence and the rapid period for personality growth and its associated emotional turmoil. It was suggested that due to the large numbers who attended the psychiatric out-patient clinic with non identifiable psychiatric illness, residency in general practice and internal medicine should include a posting in Psychiatry and that the national health care should pay a greater attention to mental health.