Swedish researchers have found that children adopted from foreign countries face more emotional problems than native-born children living with their natural parents. Mental health and social difficulties appear more common among foreign born adoptees.

The study, reported in the medical journal The Lancet, looks at 11,000 Asian and Latin American children adopted in Sweden in the 1970s and early 1980s.

Sweden is ideal for such research because it has the world's largest per capita number of adoptees from other nations. This is the result of the decline in the number of Swedish children available for adoption in the late-1960s.

Pediatrician Anders Hjern of the Swedish National Board of Health and Welfare and colleagues found that by the time the foreign adoptees were teenagers or young adults, they were at higher risk for maladjustment than children born in Sweden to Swedish parents. They were three to five times more likely to commit or attempt suicide, be admitted for a psychiatric disorder, or abuse alcohol or drugs.

"Children adopted from overseas are vulnerable in comparison with other children," he said. "Adoptive parents have to be aware of the need of these children for support and not hesitate to seek professional help when they see signs of that kind of need."

The researchers say the problems are most likely related to deprivation the children may have experienced in their homelands, such as poverty, poor prenatal care, and malnutrition. They suggest that discrimination and racism in Sweden may play a role, too.

But despite the higher risk of social troubles, the number affected is only a minority of foreign-born adoptees. Eighty-four percent of the boys and 92 percent of the girls in the study coped well. Child psychiatrist Wun Jung Kim of the Medical College of Ohio says this is seen in other studies from Europe and the United States.

"A certain group of adoptees has a higher risk, but the majority of them, despite some inherent risk, do well under the nurturing, caring environment of adoptive homes," he said.

Indeed, the Swedish researchers say their findings suggest that adoptive parents as a group are more competent than other parents, a finding also reported in previous studies.

Dr. Kim, a South Korean native, says the data on the adoptees with emotional difficulties should not deter people from choosing babies from other nations.

"We have to think of the children first," he said. "What will be the alternative if we do not arrange adoption? Some of them may be subjected to much worse conditions than what they experience in adoption and they may do a lot worse than we found in this research."

Although only a minority of foreign adoptees are troubled, study leader Anders Hjern says adoption agencies should nevertheless inform prospective adoptive parents of the risks. Moreover, he says psychiatric professionals should do a better job supporting such children into adulthood.

"It's very important that people working in psychiatric services take these problems seriously when people come for help," he said.