[Reflections on international adoption].

In paediatric psychiatry, we often encounter French families who have chosen for international adoption of foreign children. From our clinical cases and a review of the literature, we have cited several circumstances which can lead to separation following adoption, either due to a rejection of the adopted by the adopting family or vica-versa: cases in which the adopted children are older or even young adolescents, simultaneous adoption of more than one child, adoption of psychologically disturbed children with a history of neglect or abuse by a previous guardian, cases in which the adopting parents are inadequately prepared due to international adoption procedures allowing the rapid accession of the adoption and cases with a poor understanding of the adoption legislation on the part of the biological parents or the child being adopted. These risque factors, relatively specific to international adoption, can in isolation or by a combination of factors lead to failure in the adoption. Subsequent separation after adoption often leads to institutionalization and further rejection.