Investigators of a cohort study in this week's issue of THE LANCET have found that children adopted from foreign countries to homes in Sweden have a higher risk of severe mental health problems and social maladjustment in adolescence and young adulthood than do children born in Sweden to Swedish parents.

In Sweden, the late 1960s saw a decrease in the number of Swedish children available for adoption, and thus adoption of children born abroad became much more common. Now, many of these intercountry adoptees are reaching adolescence and young adulthood, and the social adjustment and mental health of these individuals is becoming important. Generally, children adapt well during their preschool and early school years, but less is known about their adjustment at adolescence.

Anders Hjern and colleagues used Swedish National Registers to identify adoptees and three comparison groups from children who were born in 1970-79 who were still alive and residents of Sweden in 1985. The investigators compared mental health problems, suicide, and drug or alcohol abuse between the intercountry adoptees; children born in Sweden to two Swedish-born parents (general population); Swedish-born siblings of adoptees (sibling group); and children born in Latin America or Asia who had arrived in Sweden before their seventh birthday, but who had a mother who was born in their continent of origin (immigrant group).

After adjustment for socioeconomic factors and parental risk factors, intercountry adoptees were about three to five times more likely to commit suicide, attempt suicide, be admitted for a psychiatric disorder, and abuse alcohol or drugs than were children in the general population group.

Anders Hjern comments: "The magnitude of the problems of help-seeking intercountry adoptees is often underestimated because of a socially established adoptive home. Profe
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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
8-Aug-2002