RESUMO
BACKGROUND: Child sexual abuse is difficult to diagnose in children and it is a challenging task for all involved medical disciplines of a medical child protection unit. The present study describes the factors that led patients to be presented to a child protection unit under the suspicion of sexual abuse and the diagnostic instruments which were used in order to substantiate or prove suspicious fact. PATIENTS AND METHOD: This study was conducted retrospectively on the basis of 210 children and adolescents ranged in age between 4 months and 18 years, who were presented to the medical child protection unit of Frankfurt am Main with suspected sexual abuse in the period from 2010 to 2015. 173 cases were analyzed in more detail. The cases were analyzed with the help of standardized documentation sheet and suspicious facts were evaluated with regard to their significance. RESULTS: A total of 173 patient records were analyzed in more detail containing cases of suspected child sexual abuse. The majority of the children and teenager were female and younger than 10. Often the father was accused of sexual abuse and parents were separated or in custody battle. The patient's statements were crucial for substantiation of suspicious fact in 60% of the cases. The assessment was more certain if the alleged perpetrator was not part of the close family and if other forms of physical violence were associated. CONCLUSION: The study shows that gynecological respectively anogenital findings do not represent the key evidence for the substantiation of sexual abuse allegations. Instead, it underlines the significance of further diagnostic methods, in particular the psychological and anamnestic evaluation.
