Norwegian Institute of Public Health, Bergen and the Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health.
Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health.
J Am Acad Child Adolesc Psychiatry. 2017 Mar;56(3):203-213.e1. doi: 10.1016/j.jaac.2016.12.009. Epub 2016 Dec 27.
To investigate whether mental health problems differ between internationally adopted adolescents and their non-adopted peers and examine design and sample characteristics that might underlie differences among studies.
Studies published through August 2015 were collected through Embase, Medline, PsychINFO, Web of Science, ERIC, and Svemed+. Combined effect estimates were calculated using random-effects models.
Eleven studies investigating 17,919 adoptees and 1,090,289 non-adopted peers were included in the meta-analysis. Internationally adopted adolescents reported more mental health problems across domains than their peers, with effect estimates (standardized mean differences [SMDs]) of 0.16 (95% CI 0.03 to 0.28) for questionnaire-based studies and 0.70 (95% CI 0.50 to 0.90) for register-based studies. They also reported significantly more externalizing difficulties (SMD 0.20, 95% CI 0.03 to 0.38), although the effect estimate for internalizing difficulties was not statistically significant (SMD 0.10, 95% CI -0.03 to 0.24). Studies using categorical measurements of mental health problems, indicating more serious problems, yielded larger effect estimates than continuous measurements (SMD 0.31, 95% CI 0.21 to 0.41; SMD 0.13, 95% CI -0.01 to 0.26, respectively). The difference in mental health problems between international adoptees and their peers was somewhat larger when using parent report compared with self-report. More recent studies (conducted in 1995 and later) yielded larger estimates than older studies, although no significant difference was found for this analysis or subgroup analyses investigating sex and age at adoption.
Although most internationally adopted adolescents are well adjusted, adoptees as a group report higher levels of mental health problems compared with non-adopted peers. This difference should be acknowledged and adequate support services should be made available.
调查国际收养青少年与非收养青少年的心理健康问题是否存在差异，并探讨可能导致研究间差异的设计和样本特征。
通过 Embase、Medline、PsychINFO、Web of Science、ERIC 和 Svemed+ 收集截至 2015 年 8 月发表的研究。采用随机效应模型计算合并效应估计值。
纳入了 11 项研究，共涉及 17919 名收养儿和 1090289 名非收养儿。国际收养儿在各领域的心理健康问题报告均多于其同龄人，基于问卷的研究的效应估计值（标准化均数差 [SMD]）为 0.16（95% CI 0.03 至 0.28），基于登记的研究为 0.70（95% CI 0.50 至 0.90）。他们还报告了明显更多的外化问题（SMD 0.20，95% CI 0.03 至 0.38），尽管内化问题的效应估计值无统计学意义（SMD 0.10，95% CI -0.03 至 0.24）。使用心理健康问题的分类测量方法，表明更严重问题的研究得出的效应估计值大于连续测量方法（SMD 0.31，95% CI 0.21 至 0.41；SMD 0.13，95% CI -0.01 至 0.26）。与自我报告相比，使用父母报告时，国际收养儿与同龄人之间的心理健康问题差异更大。虽然对于此分析或按收养时的性别和年龄进行的亚组分析均未发现差异，但最近的研究（1995 年及以后进行的研究）得出的估计值大于早期的研究。
尽管大多数国际收养儿适应良好，但作为一个群体，收养儿报告的心理健康问题水平高于非收养同龄人。应认识到这一差异，并提供足够的支持服务。
