Psychiatric disorders in adopted children: A profile from the Ontario Child Health Study
Studies of clinical populations suggest that adopted children are overrepresented among children using mental health facilities, whereas studies using non clinical populations of adopted children have reached mixed conclusions about whether or not there is an increased psychological risk associated with adoption. Data from the Ontario Child Health Study, a community survey of children aged four to 16 years, which included a subpopulation of adopted children, were used to: 1. profile the characteristics of adoptive families; 2. examine the strength of adoptive status as a marker for psychiatric and educational morbidity; and 3. determine the extent to which adoptive status has an independent relationship with psychiatric and educational morbidities. The findings were: 1. adoptive mothers were significantly older than non adoptive mothers, but otherwise adoptive families did not differ significantly from non adoptive families, 2. adoption in boys, but not in girls, was a significant marker for psychiatric disorder and poor school performance; adoption in adolescent girls was a significant marker for substance use; and 3. multivariate analyses demonstrated no independent effect of adoption on psychiatric disorder or poor school performance; for adolescents, adoptive status did have an independent relationship with substance use for girls. The implications of these findings will be discussed.
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ABSTRACT: Introdução/Objetivos: Estudos realizados em diferentes países demonstram que a proporção de crianças e ado- lescentes adotivos atendidos em clínicas psiquiátricas é maior em relação à verificada nas demais clínicas e na população em geral. O objetivo deste estudo é verificar a prevalência de adoção em amostra clínica e não-clínica, identificando possíveis associações entre tipos de adoção (extrafamiliar e intrafamiliar) e procura de serviço psiquiátrico. Métodos: Estudo de corte transversal, envolvendo crianças de seis a 14 anos: amostra clínica (G1) de um serviço de psiquiatria da infância e da adolescência de uma região da cidade de São Paulo (n=551) e amostra não-clínica (G2) de uma escola localizada na mesma região (n=365). Resultados: A proporção de meninos foi significantemente maior no G1 que no G2 (p
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ABSTRACT: Socioeconomic inequalities in health research comprises the investigation of the pathways through which differential access to resources affects the distribution of morbidity and mortality in the population. Because many of the factors that influence health are cumulative, researchers have incorporated a life course approach into their work by linking socioeconomic conditions in one stage of the life course to health at a later stage. The childhood period has acquired particular significance due to conflicting theories about the relative importance of early life events for health inequalities during adulthood. Using seven waves of the child component of the National Longitudinal Study of Youth (1986-98), I employ generalized linear mixed models to examine the effect of household income on child physical and mental health over the entire childhood period. The results of this dissertation support the hypothesis that household income influences the physical and mental health of children, both concurrently and over time. In generalized linear mixed models, the stable component of household income, that is, the average household income for a given child over the period in which he or she is observed, exerts a strong influence on risk for child chronic health limitation, child anxiety/depression and antisocial behaviour, and to a lesser extent, child medically attended accident or injury. However, the dynamic component of household income, defined as deviations in household income over time from the observed average of that household, is mostly unrelated to child health. These findings have broader implications for life course theory and for the discipline of sociology as health inequalities researchers track the impact of socially significant events over time and reveal the long term processes underlying the social distribution of health.
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