# Associations of Duration of Preadoption Out-of-home Care, Genetic Risk for Schizophrenia Spectrum Disorders and Adoptive Family Functioning with Later Psychiatric Disorders of Adoptees

## TL;DR

This study shows that the length of time children spend in out-of-home care before adoption and the quality of their adoptive family environment affect their later mental health, especially for those with a high genetic risk of schizophrenia.

## Contribution

The study uniquely combines genetic risk, early care duration, and adoptive family functioning to predict later psychiatric outcomes in adoptees.

## Key findings

- HR adoptees with over 6 months in out-of-home care had significantly higher psychiatric disorder likelihood than LR adoptees.
- Adoptees with 6 months or less in out-of-home care showed higher disorder risk if their adoptive families had dysfunctional processes.
- Early placement and a well-functioning adoptive family are especially beneficial for children with high genetic risk.

## Abstract

The objective was to examine the impacts of duration of preadoption out-of-home care and adoptive family functioning on later psychiatric morbidity of adoptees with high (HR) and low (LR) genetic risk for schizophrenia spectrum disorders. The study uses nationwide data from the Finnish Adoptive Family Study of Schizophrenia. The study population in this substudy consisted of 43 h adoptees and 128 LR adoptees. Of these adoptees, 90 had spent 0–6 months and 81 over 6 months in preadoption out-of-home care. The family functioning of adoptive families was assessed based on Global Family Ratings and psychiatric disorders on DSM-III-R criteria. The results showed that among the adoptees with over 6 months in preadoption out-of-home care, the likelihood for psychiatric disorders was significantly increased in HR adoptees compared to LR adoptees. In adoptees with 6 months or less in preadoption out-of-home care, an increased likelihood for psychiatric disorders was found among those living in adoptive families with dysfunctional processes. These findings indicate that especially for HR children, a well-functioning early caregiving environment is crucial in terms of subsequent mental wellbeing. The results emphasize that when adoption is necessary, early placement and well-functioning adoptive family environment are beneficial to children.