BEHAVIORAL AND MENTAL DISORDERS
RISK OF MENTAL DISORDERS IN INTERNATIONAL ADOPTION
Pre-Adoptive Medical Records
Family medical history, especially mental health history, is rarely if ever available for internationally adopted children. If available, interpretation of psychiatric diagnoses from culturally different medical systems is difficult. For example, a birth mother reported to have "depression" may have the expected emotional responses to her difficult circumstances which require that she relinquish her child, rather than major depressive or bipolar disorder. A recent small survey suggests that most relinquishing birth mothers in Russia are clinically depressed.
"Antisocial personality" may refer to a parent who has engaged in minor or major criminal activity, or simply to a young woman who has become pregnant out of wedlock. Parents may be incarcerated for reasons that might or might not be valid in the United States. "Oligophrenia" is seen occasionally on pre-adoptive records from Eastern Europe. This has been variously translated as mental retardation, depression, and schizophrenia. These examples highlight the difficulties in understanding various categories of psychiatric illnesses from another culture.
Lack of information about family mental health disorders should not be construed to mean that no problems exist. Little information is available about birth fathers. However, birth mothers with mental retardation, mental illness, antisocial behaviors, and /or substance abuse likely favor birth fathers with similar qualities. Thus, some children inherit a double dose of unfavorable genes.
Finally, fabricated or exaggerated psychiatric diagnoses are occasionally included on pre-adoptive medical records for "legal reasons" (e.g. to expedite the adoption of the child). It is usually impossible to differentiate among these various situations, but a request to the adoption agency or intermediary for further information is often warranted.
From THE HANDBOOK OF INTERNATIONAL ADOPTION MEDICINE by Laurie C. Miller. © 2004 by Oxford University Press, Inc. Used by Permission.