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 [F] Diseases Research  / PubMed Research Articles  /
Adult psychosocial outcomes of men and women who were looked-after or adopted as children: prospective observational study.




BMJ open 02 ; 8(2)


Teyhan A1; Wijedasa D2; Macleod J3;

Author Information
  • 1Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
  • 2School for Policy Studies, University of Bristol, Bristol, UK.
  • 3Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.


OBJECTIVE: To investigate whether men and women who were looked-after (in public care) or adopted as children are at increased risk of adverse psychological and social outcomes in adulthood.

DESIGN, SETTING: Prospective observational study using the Avon Longitudinal Study of Parents and Children, which recruited pregnant women and their male partners in and around Bristol, UK in the early 1990s.

PARTICIPANTS: 8775 women and 3654 men who completed questionnaires at recruitment (mean age: women 29; men 32) and 5 years later.

EXPOSURE: Childhood public care status: looked-after; adopted; not looked-after or adopted (reference group).

OUTCOMES: Substance use (alcohol, cannabis, tobacco) prepregnancy and 5 years later; if ever had addiction; anxiety and depression during pregnancy and 5 years later; if ever had mental health problem; social support during pregnancy; criminal conviction.

RESULTS: For women, 2.7% were adopted and 1.8% had been looked-after; for men, 2.4% and 1.4%, respectively. The looked-after group reported the poorest outcomes overall, but this was not a universal pattern, and there were gender differences. Smoking rates were high for both the looked-after (men 47%, women 58%) and adopted (men 44%, women 40%) groups relative to the reference group (both 28%). The looked-after group were at increased risk of a high depression score (men: 26% vs 11%, OR 2.9 (95% CI 1.5 to 5.6); women: 24% vs 9%, 3.4 (2.2 to 5.0)). A high anxiety score was reported by 10% of the reference women, compared with 26% of those looked-after (3.0 (2.0 to 4.5)) and 17% of those adopted (1.8 (1.2 to 2.6)). Looked-after men and women reported the lowest social support, while criminal convictions and addiction were highest for looked-after men. Adjustment for adult socioeconomic position generally attenuated associations for the looked-after group.

CONCLUSIONS: The needs of those who experience public care as children persist into adulthood. Health and social care providers should recognise this.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.




Publication Type: Journal Article, Research Support, Non-U.S. Gov't

This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.

Last Modified:   2016-03-27

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