Fostering and mental health

There are approximately half a million children and adolescents in foster care in the U.S. and it is estimated that between 42 and 60% of them have emotional and behavioural problems. Despite the high prevalence of mental-health problems in these children little is known about how such problems affect the outcome of foster placements. A study of 5,978 children in Illinois looked at their medical records to see whether they had received inpatient mental-health care and followed their progress for several years to see how their foster placements turned out. Five percent of the children had had at least one episode of inpatient mental-health care prior to being placed in foster care. The children who received inpatient psychiatric care had a substantially greater risk for parent-child separation. They were also at a greater risk for frequent placement disruptions and were less likely to be reunited with their birth family or permanently adopted. About half of the sample experienced more than three placement changes during their first spell in foster care. Having had inpatient care raised the risk of placement instability by 75% among White children and 24% among African-American children.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/01/090113133142.htm

Adoption and mental-health problems in adolescence

In addition to 'domestic' adoption worldwide approximately 40,000 children per year are moved between 100 countries through adoption. Despite the popularity of adoption there is a persistent concern that adopted children may be at heightened risk of mental health or adjustment problems. Researchers at the University of Minnesota in the U.S. studied 1,232 adolescents (11-21) comparing those who had not been adopted, those who had been 'internationally' adopted and those who had been adopted from within the U.S. Being adopted approximately doubled the risk of attention deficit disorder and oppositional defiant disorder. Compared to international adoptees domestic adoptees had higher odds of having a disruptive disorder. However, international adoptees were at higher risk of major depressive disorder and separation anxiety disorder.

You can find out more about this research at

http://psychcentral.com/news/2008/05/06/adopted-children-at-risk-for-adhd-other-mental-disorders/2234.html

Intercountry adoption and mental illness

Intercountry adoption is increasingly common and currently involves more than 40,000 children a year in over 100 countries. Large numbers of children adopted from foreign countries are now reaching adulthood, the age of onset for most serious mental disorders, yet little is known about the effects of inter-country adoption on children's mental health. A study of children in Denmark who were adopted from abroad has found that they had a 2.9 times greater risk of developing schizophrenia than native Danes. The increased risk was independent of age at, or the region of, adoption, mental illness among foster parents, the age of foster parents or whether the foster parents lived in the city or the countryside. The foster mother's own children also had an increased (1.92 times) risk of developing schizophrenia. The researchers were not sure why this might be so but speculated that it could be due to hereditary factors in the children, traumatic experiences suffered by children prior to adoption or the disruption caused by the adoption and resettlement process itself.

Cantor-Graae, Elizabeth and Pedersen, Carsten Becker - Risk for schizophrenia in intercountry adoptees : a Danish population-based cohort study Journal of Child Psychology and Psychiatry November 2007, 48(11), 1053-1060