[Adoption and its psychiatric aspects]

Adoption has changed in history, in different cultures, in law, in its goals, its functions, its modalities. The study of the adoptive condition is worthwhile for theoretical research (psychopathology, genetics, etc.) and for clinical practice (prevention, selection and motivation analysis of adopting parents). It is dangerous and too simple to explain pathology by adoption. However, there is a specific psychopathology of adoptees : 1. by maternal deprivation and abandonnement pathology (more frequent and more important), 2. by the adoptive situation condition itself. We review some hypotheses, particularly the concept of "Family romance". The adopted child undergoes more frequent examinations, both pediatric and psychiatric, than the ordinary child (this may be explained by parental anxiety and child acting out behavior). Certain American statistics on this appear to be significant. On the other hand, there is a silent pathology (the majority ?) : we found it frequently in the youngest children in France. We discuss the problem of psychiatric selection of adoptive parents and adoptive children, its legitimacy, its methodes ; psychopathology and motivations of the adoptive patents ; the problem of the revelation of adoption to the child ; the problem of sterility (it is often incompletely explored and treated). Adoption may not be the best solution for most of the abandonned children and sterile couples.