Mentale problemer som følge av alvorlig emosjonell omsorgssvikt
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Background: Adoption of children from non-Western countries is very common. Many of these children experience severe emotional deprivation before adoption, often causing extensive problems for the child and considerable challenges for the health service. Material and methods: The Romanian Adoptees Study (RAS) is a longitudinal study of 165 Romanian children exposed to severe emotional deprivation (most of them in institutions) before they were adopted by English couples, as well as 52 controls. Main results are presented. Results: The Romanian children were malnourished and had a very poor mental health when adopted. The improvement showed by most children at age six years was impressive. However, a considerable number still showed attachment problems, inattention/overactivity, quasi-autistic features or cognitive impairment. The problems were considerably more frequent in children adopted before six months of age, and were rarely found in the control group. Emotional difficulties, poor peer relationships and conduct problems were not associated with severe emotional deprivation. No significant gender differences were found. Interpretation: Extensive emotional deprivation is clearly associated with severe mental problems. A change to better care (by adoption) improves the prognosis dramatically. However, in children adopted after six months of age the problems persist to a considerable extent.