Suicidal behaviour in national and international adult adoptees
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Previous studies have shown an elevated risk for suicidal behaviour in adolescent and young adult international adoptees. Comparisons between national and international adoptees in this respect have been inconclusive.
A total of 6,065 international adoptees were compared to 7,340 national adoptees and 1,274,312 non-adopted study subjects, all born between 1963 and 1973 and followed up until 2002 using the National Swedish Registers. Cox regression of person years was used in multivariate analyses to compare risks for suicide death and suicide attempt.
International adoptees had clearly increased risks for suicide attempt (risk ratio 4.5 [95% confidence interval 3.7–5.5]) and suicide death (3.6 [2.6–5.2]) after adjustments for sex, age and socio-economic factors. National adoptees had lower risks than international adoptees, but had increased risks compared to non-adoptees (suicide attempt, 2.8 [2.2–3.5]; suicide death, 2.5 [1.8–3.3]). Biological parents' morbidity explained approximately one third of the increased risk for national adoptees. Female international adoptees' risk for suicide attempt was elevated to an even greater extent than in male international adoptees, when compared to the general population.
Clinicians should be aware that an increased risk for suicide and suicide attempts in international adoptees is a topic that is equally relevant to child and adult psychiatry.
Key wordsinternational adoption national adoption suicide suicide attempt cohort study gender
- 1.Andersson G (2000) International adoption in Sweden. The perspective of the Adoption Centre in its 30th year. In: Selman P (ed) International adoption: development, trends and perspectives. British Association for Adoption and Fostering (BAAF), London, pp 346–367Google Scholar
- 2.Bagley C, Young L, Scully A (1993) International and transracial adoptions. A mental health perspective. Avebury, AldershotGoogle Scholar
- 6.Bertolote JM (2001) Suicide in the world: an epidemiological overview 1959–2000. In: Wasserman D (ed) Suicide—an unnecessary death. Martin Dunitz, London, pp 3–10Google Scholar
- 8.Bohman M (1970) Adopted children and their families—a follow-up study of adopted children, their background, environment and adjustment. Proprius, StockholmGoogle Scholar
- 9.Bohman M (1995) De svenska adoptivbarnen: det sociala arvet i ett historiskt perspektiv (Adopted children in Sweden: the theory of social inheritage in a historical perspective). Socialmed Tidskr 8:308–319Google Scholar
- 10.Brodzinsky DM (1987) Adjustment to adoption: a psychosocial perspective. Clin Psychol Rev 7:25–47Google Scholar
- 11.Brooks D, Barth RP (1999) Adult transracial and inracial adoptees: effects of race, gender, adoptive family structure, and placement history on adjustment outcomes. Am J Orthopsychiatr 69:87–99Google Scholar
- 20.Irhammar M, Cederblad M (2000) Outcome of international adoption in Sweden. In: Selman P (ed) International adoption: development, trends and perspectives. British Association for Adoption and Fostering (BAAF), London, pp 143–163Google Scholar
- 22.Levy-Shiff R, Zoran N, Schulman S (1997) International and domestic adoption: child, parents, and family adjustment. Int J Behav Dev 20:109–129Google Scholar
- 25.Nordlöf B (2001) Svenska adoptioner i Stockholm 1918–1973 (Swedish adoptions in Stockholm 1918–1973). FoU-rapport 2001: 8. Socialtjänstförvaltningen. Forsknings- och utvecklingsenheten, StockholmGoogle Scholar
- 28.Rooth DO (2002) Adopted children in the labor market—discrimination or unobserved characteristics. Int Migr Q Rev 40:71–98Google Scholar
- 30.Simon RJ, Altstein H (1996) The case for transracial adoption. Child Youth Serv Rev 18:5–22Google Scholar
- 31.Slap G, Goodman E, Huang B (2001) Adoption as a risk factor for attempted suicide during adolescence. Pediatrics 108(E30):1–8Google Scholar
- 33.SPSS Inc. (2004) Advanced statistics 12.0. SPSS Inc., ChicagoGoogle Scholar
- 35.Statistics Sweden (1982) Socio-economic classification (SEI). Statistics Sweden, StockholmGoogle Scholar
- 36.Statistics Sweden (2004) Statistical yearbook of Sweden 2004. Statistics Sweden, Stockholm, pp 267–306Google Scholar
- 40.Verhulst FC, Versluis-den Bieman HJ (1995) Developmental course of problem behaviors in adolescent adoptees. J Am Acad Child Adolesc Psych 34:151–159Google Scholar
- 41.Verhulst FC, Althaus M, Versluis-den Bieman HJ (1990) Problem behavior in international adoptees: II. Age at placement. J Am Acad Child Adolesc Psych 29:104–111Google Scholar
- 42.Verhulst FC, Althaus M, Versluis-den Bieman HJ (1992) Damaging backgrounds: later adjustment of international adoptees. J Am Acad Child Adolesc Psych 31:518–524Google Scholar
- 44.Vinnerljung B (1992) 235 Syskon med olika uppväxtöden (235 Siblings with contrasting childhood fates). Lunds Universitet, Meddelanden från socialhögskolan 1992:5 LundGoogle Scholar