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Overseas Adoptees May Have Health Problems

Higher Rate of Depression, Suicide, Substance Abuse
By
WebMD Health News
Reviewed by Gary D. Vogin, MD

Aug. 8, 2002 -- More Americans than ever are adopting from foreign countries, with nearly 19,000 international adoptions taking place just last year. While the vast majority of children thrive, new research from Sweden suggests that international adoptees may be at risk for depression and other mental health problems as they get older.

Using a national mental health registry, the Swedish researchers concluded that children adopted from abroad had a higher incidence of suicide, substance abuse, and treatment for depression during their adolescent and early adult years than children who were born in Sweden or immigrated to the country with a parent.

The authors are quick to point out that most of the adoptees studied -- 82% of the boys and 92% of the girls -- had no record of mental health problems at all. But after adjusting for other risk factors, foreign adoptees were three to five times more likely to commit suicide, attempt suicide, receive treatment for psychiatric problems, or abuse alcohol or drugs than were those in the general population. The findings are reported Aug. 10 in The Lancet.

"The message here is certainly not that children who are adopted internationally are going to have mental health or adjustment problems," lead author Anders Hjern, tells WebMD. "We don't really know if these findings represent a real difference because there were so many things that we could not measure with a study like this."

Hjern says more research is needed to determine the true frequency of mental health and adjustment problems among internationally adopted children, and to better understand why these problems occur. He adds that adoption agencies should do a better job of following children and educating parents about the potential for adjustment problems.

Susan Soon-keum Cox, now 50, was adopted from Korea in 1956, making her one of the first international adoptees in the U.S. She now works with the adoption agency Holt International, which has placed close to 50,000 orphans from other countries with American families over the past five decades.

She says adjustment issues vary from child to child, but there tend to be fewer problems these days than in the past. Holt International recently took part in research following up on Korean and Vietnamese adoptees now in their mid 20s and older. The most frequently reported problems were cultural and racial identity issues.

"When I was adopted, the prevailing belief was that children needed to become acclimated and Americanized as quickly as possible so that they would fit in," she says. "We now know, after a couple of generations, that children become acclimated almost by osmosis. A more difficult challenge is to keep them connected to the country and cultural heritage of their birth to give them a clear sense of identify. We are much better at doing that now."

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