Research suggests that adopted children have an increase in mental health problems. However, little is known about the type and severity of these diagnoses. The mental and psychological health of internationally adopted adolescents is of particular interest, as this is a period of life where many questions arise related to identity and individuality. Therefore, we reviewed a database of children and adolescents seen in consultation in a psychiatric service directed towards internationally adopted children and their families to determine the patterns of diagnoses and associated demographic factors.
A database of all 465 children seen between 2010-15 in the international adoption consultation service (CAI) at Hospitalier St. Anne, Paris was reviewed. Only the 226 children seen for initial visits between the ages of 9 and 20 years were included for this analysis. Of these, only 163 had the diagnosis code for the visit correctly entered. These 163 children (135M:91F) were the subject of this analysis; 71% were seen by the same child psychiatrist. Diagnoses were grouped into 6 clusters, using the standard « Classification internationale des maladies, 10e révision (CIM-10) », as follows : Neurotic disorders, Disorders of psychologic development, Behavioral and conduct disorders, Emotional disorders of childhood, Attachment disorders, and Other.
Average age at first visit was 13.40+3.02 years. Children had been adopted from 29 different countries (Eastern Europe [EE] 53%, Central/South America [AM] 21%, Asia [AS] 15%, Africa [AF] 8%, and Other 3%). Age at arrival ranged from 4 months to 6 years. Age at first visit did not relate to continent of origin. Attachment disorders were the most common diagnosis (39%), followed by Behavioral and conduct disorders (17%), Disorders of psychologic development (15%), Neurotic disorders (11%), Emotional disorders of childhood (10%), and other (8%). Diagnosis did not relate to age at visit, family composition (single parents vs. couples), or adoption as part of a sibling group. However, continent of origin related significantly to diagnosis (overall 2 37.1, p=.02), with 51% of EE children diagnosed with attachment disorders (vs. 21-30% for the other continents, p=.0042). An additional trend included: 39% of AM children were diagnosed with Neurotic Disorders (vs 11-22% from the other continents, p=.07).
In a child psychiatry specialty consultation service in France, dedicated to internationally adopted children, a wide range of diagnoses were seen among adolescents. Attachment disorders were the most common conditions identified, and these were particularly prevalent among children adopted from EE. Multiple other diagnoses were also established, highlighting the complexity of mental health problems in this population of adolescents.