Prevalence and associated factors of adolescent psychological abuse, neglect in Western China a multi-center cross-sectional study.

Background: The western region of China has a dense population, relatively underdeveloped economy, and a significant number of left-behind children. Currently, the prevalence of adolescent psychological abuse, neglect, and the factors associated with these issues in the region remain unclear. This study aims to evaluate the current status of adolescent psychological abuse and neglect and its associated factors in this region.Methods: Data were collected from 50 schools in western China through cluster sampling to target adolescents aged 12 to 18. A comprehensive survey form was used to collect socio-demographic characteristics of adolescents. The Child Psychological Abuse and Neglect Scale was employed to assess the current psychological abuse and neglect of adolescents. Independent samples t-tests were used for inter-group comparisons. A Directed Acyclic Graph was constructed for controlling confounding variables. Subsequently, binary logistic regression analysis was performed, and a nomogram risk factors model was developed using R Studio.Results: This study included 12,743 teenagers, with an average age of 15.53(±1.39) years. Among them, 4,965 individuals, accounting for 39.0%, reported experiences of psychological abuse, while 4,167 individuals, accounting for 32.7%, reported experiences of neglect. The rates of psychological abuse and neglect in adolescents are influenced by gender, grade, left-behind experience, parental marital status, and living on campus (P < .05).Conclusion: Adolescents in western China exhibit higher rates of psychological abuse and neglect compared to those in the eastern and northern regions of China. Gender, grade, left-behind experience, and family factors significantly influence the psychological abuse and neglect of adolescents.

This study is the first large-scale, multi-centre, cross-sectional analysis of psychological abuse and neglect among youth in Western China, a region with relatively underdeveloped economic and social conditions.This article fills in the gap in the region's research on psychological abuse and neglect by addressing the issues of small sample size, limited coverage, and a lack of variables included.This provides a crucial theoretical foundation for enhancing the mental well-being of youth in this region and preventing psychological and mental illnesses among youth.

Is it the Child’s Fault? Maternal Attributions in Child Abuse and Neglect / ¿Es Culpa del Niño? Atribuciones Maternas en el Abuso y la Negligencia Infantil

Background: Among the parental cognitions explaining maladaptive parenting, attributions about a child’s misbehavior seem important. However, there is little research on neglectful parents, and the different patterns of parental attributions associated with child abuse and child neglect are still underexplained. The current study examines parental attributions associated with child abuse and child neglect. Method: Mothers (N = 218) were asked to evaluate vignettes describing child transgressions, half of which were followed by situational information. Child abuse and child neglect were evaluated through mothers’ and professionals’ reports. Results: Preliminary results indicated that the child’s age and maternal socioeconomic status were significantly correlated with attributions and child abuse and neglect scores and thus were controlled in the models. The results from hierarchical regressions indicated that dispositional attributions were associated with higher abuse scores (reported by mothers), even in the presence of situational information. Likewise, dispositional attributions were associated with higher neglect scores (reported by professionals), but the effect was no longer significant in the presence of situational information. Conclusions: These findings contribute to the current socio-cognitive approaches to child maltreatment and provide relevant input for understanding the different attributional mechanisms underlying child abuse and neglect.(AU)

Antecedentes: Entre las cogniciones parentales que explican la parentalidad desadaptativa, las atribuciones sobre el comportamiento del niño parecen importantes. Sin embargo, hay pocas investigaciones sobre los padres negligentes, y los patrones de atribuciones parentales que se asocian con el abuso y la negligencia siguen sin explicarse. Éste estudio examina las atribuciones parentales asociadas con el abuso y la negligencia infantil. Método: La muestra estaba compuesta por 218 madres que evaluaron viñetas que describían transgresiones infantiles, la mitad con información situacional. Abuso y negligencia se evaluaron a través de informes de madres y profesionales. Resultados: Los resultados indicaron que la edad del niño y el estatus socioeconómico estaban correlacionados con las atribuciones y con el abuso y negligencia, por lo que fueron controlados en los modelos. Los resultados de las regresiones jerárquicas indicaron que las atribuciones disposicionales se asociaron con el abuso (informes de madres), incluso en presencia de información situacional. Las atribuciones disposicionales se asociaron con la negligencia (informes de profesionales), pero no hay efecto en presencia de información situacional. Conclusiones: Estos hallazgos corroboran a los actuales enfoques sociocognitivos del maltrato infantil y proporcionan aportaciones relevantes para entender los diferentes mecanismos atribucionales que subyacen al abuso y la negligencia infantil.(AU)

Notifications of physical, sexual and emotional violence and neglect against children in Brazil, 2011-2019: an ecological time-series study / Notificaciones de violencia física, sexual, psicológica y negligencia practicada contra niños en Brasil, 2011-2019: estudio ecológico de serie temporal / Notificações de violência física, violência sexual, violência psicológica e negligência praticadas contra crianças no Brasil, 2011-2019: estudo ecológico de série temporal

ABSTRACT Objective To describe the temporal trend of notifications of physical, sexual and emotional violence and neglect against children in Brazil between 2011 and 2019. Methods This was an ecological time-series study based on notifications of violence against children aged 0-9 years held on the Brazilian Notifiable Health Conditions Information System. Age-adjusted notification rates were calculated for Brazil as a whole, by national macro-region and by sex. Trends were assessed using Joinpoint Regression. Results We analyzed 88,820 notifications of physical violence, 87,141 notifications of sexual violence, 52,359 notifications of emotional violence and 166,664 notifications of neglect. A rising trend was identified for notifications of physical, sexual and emotional violence and neglect for Brazil as a whole and for both sexes. Neglect accounted for the highest rate (95.24 notifications per 100,000 children in 2019). The Northeast and Southeast macro-regions had rising trends for all forms of violence. Conclusion Notifications of physical, sexual and emotional violence and neglect showed rising trends in Brazil in the period studied.

RESUMEN Objetivo Describir la tendencia temporal de notificaciones de violencia física, sexual, psicológica y negligencia practicada contra niños en Brasil entre 2011 y 2019. Métodos Estudio ecológico de series temporales de notificaciones registradas en el Sistema de Información de Agravamientos de Notificación contra niños (0-9 años). Se calcularon las tasas de notificación ajustadas por edad para Brasil por macrorregión y sexo. Se analizó la tendencia mediante regresión joinpoint. Resultados Se incluyeron 88.820 notificaciones de violencia física, 87.141 de violencia sexual, 52.359 de violencia psicológica y 166.664 de negligencia. Se identificó una tendencia ascendente de las notificaciones de violencia física, sexual y psicológica y de negligencia para Brasil y para ambos sexos. La negligencia tuvo la tasa más alta (95,24 notificaciones por 100.000 en 2019).Noreste y Sureste presentaron tendencia creciente en todos los tipos de violencia. Conclusión Las notificaciones de violencia contra los niños mostraron tendencia creciente entre 2011 y 2019 en Brasil.

RESUMO Objetivo Descrever a tendência temporal das notificações de violência física, violência sexual, violência psicológica e negligência praticadas contra crianças no Brasil, entre 2011 e 2019. Métodos Estudo ecológico de série temporal, sobre notificações de violência contra crianças de 0 a 9 anos no Sistema de Informação de Agravos de Notificação. Taxas de notificação ajustadas por idade foram calculadas para Brasil, macrorregiões nacionais e sexo. Analisou-se a tendência das taxas por regressão joinpoint. Resultados Foram analisadas 88.820 notificações de violência física, 87.141 de violência sexual, 52.359 de violência psicológica e 166.664 notificações de negligência. Identificouse tendência crescente de notificações de violência física, sexual, psicológica e negligência, para o Brasil e ambos os sexos. Negligência apresentou a maior taxa [95,24 notificações/100 mil crianças (2019)]. Nordeste e Sudeste apresentaram tendência crescente para todas as violências. Conclusão Notificações de violência física, sexual, psicológica e negligência contra crianças apresentaram tendência crescente no Brasil, no período.

Maltrato en la infancia y consumo de drogas en adolescentes de preparatoria / Child abuse and drug use in high school adolescents

Resumen Objetivo: Conocer la relación entre el maltrato en la infancia y el consumo de drogas en adolescentes. Materiales y métodos: Estudio cuantitativo, descriptivo, correlacional, transversal; mediante el muestreo aleatorio estratificado, se seleccionaron a los adolescentes de preparatoria. Se aplicó una cédula de datos personales, el Cuestionario de Maltrato en la Infancia, Test de Identificación de los Trastornos Debidos al Consumo de Alcohol, validados y utilizados en población mexicana, en investigaciones previas. Este estudio se apegó al Reglamento de la Ley General de Salud en materia de investigación para la salud. Resultados: Participaron 239 adolescentes de una preparatoria pública, las edades oscilaron entre los 15 a 19 años (M = 16.41; DE= 1.04), las mujeres predominaron con 54.5%. En la variable de maltrato en la infancia y subescalas por sexo se encontró diferencia significativa en la subescala de abuso físico mostrando que los hombres (Mdn=7.00/ M=8.11, DE=3.08) presentaron mayor puntaje de abuso físico en comparación con las mujeres (Mdn=7.00/ M=7.28, DE=2.64) con una U=5760.0, p<0.032. Al correlacionar las variables de maltrato en la infancia y consumo de drogas, se encontró una correlación positiva y estadísticamente significativa del número de drogas con el total AUDIT, el consumo sensato y dañino con el puntaje total de maltrato y las subescalas de abuso sexual, negligencia emocional y negligencia física. Conclusiones: Los hombres presentaron mayor abuso físico. En la relación entre las variables de estudio se encontró que el maltrato en la infancia, se relacionó con el consumo de alcohol dañino y con el número de drogas consumidas.

Abstract Objective: To know the relationship between abuse in childhood and drug use in adolescents. Materials and methods: Quantitative, descriptive, correlational, cross-sectional study; Using stratified random sampling, high school adolescents were selected. A personal data card, the Child Abuse Questionnaire, and the Alcohol Use Disorders Identification Test were applied, validated and used in the Mexican population, in previous investigations. This study adhered to the Regulations of the General Health Law regarding health research20. Results: 239 adolescents from a public high school participated, the ages ranged from 15 to 19 years (M = 16.41; SD = 1.04), women predominated with 54.5%. In the variable of abuse in childhood and subscales by sex, a significant difference was found in the physical abuse subscale, showing that men (Mdn = 7.00/M = 8.11, SD = 3.08) had a higher physical abuse score compared to women. (Mdn = 7.00/M = 7.28, SD = 2.64) with a U = 5760.0, p <0.032. When correlating the variables of abuse in childhood and drug use, a positive and statistically significant correlation of the number of drugs with the total AUDIT, the sensible and harmful consumption with the total score of abuse and subscales of sexual abuse, emotional neglect and neglect physical. Conclusions: Men presented more physical abuse. In the relationship between the study variables, it was found that abuse in childhood was related to the consumption of harmful alcohol and the number of drugs consumed.

The mediating role of posttraumatic stress reactions in the relationship between child abuse and physical health complaints in adolescence and young adulthood.

Background: Child abuse is associated with physical health problems in adolescence and adulthood, but the mechanisms involved are unclear. A possible mediating effect of posttraumatic stress reactions (PTSR) linking child abuse with later physical health complaints has not been fully investigated. Objective: The current study investigated whether PTSR could be a potential mediator in the relationship between child abuse and physical health complaints in adolescents and young adults. If so, we also investigated whether this was the case for different child abuse types alone or in combination. Method: The study sample comprised 506 adolescents and young adult victims of child abuse and 504 unexposed matched controls aged 16-33 from a community sample. We measured child abuse retrospectively and current PTSR at wave 1 (2013), and current physical health complaints at wave 2 (2014/15). We tested a model of PTSR as a possible mediator between child abuse and physical health complaints and conducted causal mediation analysis to estimate direct and indirect pathways. Each child abuse type was studied in isolation and in combination with other abuse types. Results: PTSR had a notable, significant mediating effect on the relationship between child abuse and physical health complaints in our overall model (average causal mediation effect; ACME = 0.14, p < 0.001), accounting for 85% of the total effect. The mediated pathway was also significant in analyses of the different child abuse types. The mediating effect of PTSR was most prominent in individuals reporting exposure to more than one child abuse type. Conclusions: The current study indicates that PTSR may be an important mediator in the relationship between child abuse and physical health complaints. Health professionals should be aware of the important role that PTSR may have in maintaining or exacerbating physical health problems in child abuse victims. However, a reverse model could not be tested in this study and the results need confirmation in future prospective studies.

Antecedentes: El maltrato infantil se encuentra asociado con problemas de salud física en la adolescencia y en la adultez, pero los mecanismos involucrados no son claros. Un posible efecto mediador de las reacciones de estrés traumático (PTSR en su sigla en inglés) relacionando el maltrato infantil con quejas de salud física posteriores no ha sido investigado suficientemente.Objetivo: El presente estudio investigó si la PTSR podría ser un mediador potencial en la relación entre el maltrato infantil y las quejas de salud física en adolescentes y adultos jóvenes. También investigamos si esto era el caso para diferentes tipos de maltrato infantil de forma individual o en combinación.Método: La muestra del estudio consistió en 506 adolescentes y adultos jóvenes víctimas de maltrato infantil y 504 controles sin exposición al maltrato con edades de 16 a 33 años provenientes de una muestra comunitaria. Medimos el maltrato infantil retrospectivamente, el actual PTSR en la ola 1 (2013), y las quejas actuales de salud física en la ola 2 (2014/2015). Pusimos a prueba un modelo de la PTSR como un posible mediador entre el maltrato infantil y las quejas de salud física y llevamos a cabo un análisis de mediación causal para estimar los efectos directos e indirectos. Cada tipo de maltrato fue estudiado de forma separada y en combinación con otros tipos de abuso.Resultados: La PTSR tuvo un efecto mediador significativo en la relación entre el maltrato infantil y las quejas de salud física en nuestro modelo general (efecto mediador causal promedio; ACME en sus siglas en inglés = 0.14, p <0.001), correspondiendo al 85% del efecto total. La mediación fue también significativa en los análisis de los diferentes tipos de maltrato infantil. El efecto mediador de la PRSR fue más prominente en aquellos individuos que reportaron la exposición a más de un tipo de maltrato infantil.Conclusiones: PTSR podría ser un mediador importante en la relación entre el maltrato infantil y las quejas de salud física. Los profesionales de la salud deberían estar conscientes del rol que la PTSR puede tener en la mantención y la exacerbación de los problemas de salud física en las víctimas de maltrato infantil. Sin embargo, un modelo reverso no pudo ser probado y los resultados necesitan confirmación en futuros estudios prospectivos.

Transformando um mundo selvagem: ajudando crianças e famílias ante a negligência na província de Quebec, Canadá / Reshaping a wild world: helping children and families facing negligence in the province of Quebec, Canada / Transformando un mundo salvaje: ayudando niños y familias ante la negligencia en la provincia de Quebec, Canadá

A negligência é um problema social complexo, com graves consequências para o cumprimento das necessidades de uma criança, pelos adultos que compõem a família da criança e da rede social; não somente pais, mas outros adultos que entram em contato com a criança (incluindo profissionais). Pela complexidade das relações sociais envolvidas, os sistemas de proteção da criança têm dificuldade de identificar e criar programas de atendimento. Na verdade, eles apresentam uma tendência a concentrar-se sobre as deficiências dos pais em relação à sua responsabilidade para com os seus filhos. Este artigo descreve a fundamentação teórica de um modelo ecossistêmico e de desenvolvimento que tem como base os serviços integrados de negligência infantil em Québec, no Canadá. Também descreve os componentes e atividades que visam a operacionalizar esse modelo ecossistêmico e o modelo de desenvolvimento de negligência infantil.

Child neglect is a complex social problem with serious consequences to the fulfillment of a child's needs, provided by adults who are the members of the child's family, and the social network; not only parents, but other adults who interrelate with the child (including professionals). Due to the complexity of the social relations involved, it is hard for child protection systems to design and develop assistance programs. In fact, they have a tendency to concentrate on parents' deficiencies concerning their responsibility for their children. This article describes the theoretical foundation of an ecosystemic and developmental model which is based on the integrated services dealing with child neglect in Quebec, Canada. It also describes the components and activities that aim to operationalize this ecosystemic and developmental model approaching child neglect.

La negligencia es un problema social complejo con graves consecuencias para el cumplimiento de las necesidades de un niño por parte de los adultos en la familia inmediata del niño y de la red social - no sólo padres, sino también otros adultos que están en contacto con el niño (incluyendo los profesionales). Por la complejidad de las relaciones sociales implicadas, los sistemas de protección de los niños tienen dificultades para identificar y crear programas de atención. De hecho, tienen una tendencia a concentrarse en las deficiencias de los padres con respecto a su responsabilidad con sus hijos. En este artículo se describe el fundamento teórico de un modelo ecosistémico y de desarrollo que constituye la base de los servicios integrados de negligencia infantil en Quebec, Canadá. También se describen los componentes y actividades que tienen como objetivo poner en práctica este modelo ecosistémico y el modelo de desarrollo de negligencia infantil.

Família e negligência: uma análise do conceito de negligência na infância / Family and neglect: an analysis of the concept of child negligence

Resumo O objetivo do artigo é problematizar as denominações de negligências direcionadas às famílias no contexto de práticas de cuidados consideradas insuficientes ou inadequadas para crianças e adolescentes. A reflexão é parte de um estudo prévio que analisou como o conceito de negligência é definido e aplicado nas produções acadêmicas nacionais e indicou que grande parte dos seus casos contra crianças é atribuída à esfera familiar. A presente discussão busca considerar as famílias em sua pluralidade. É um estudo qualitativo, desenvolvido numa perspectiva antropológica interpretativa. Os resultados apontam que há rótulos acusatórios e omissões graves em relação às configurações familiares, fatos que reforçam a complexidade de definir uma situação como negligência: as famílias podem reproduzir, praticar ou sofrer negligências.

Abstract The aim of this paper is to specify and investigate the types of negligence practiced on families in the context of healthcare that are considered to be insufficient or inappropriate for children and adolescents. These reflections are part of a previous study that analyzed how the concept of negligence is defined and applied in Brazilian academic studies, and indicated that a large part of the cases of negligence practiced against children is attributed to the sphere of the family. This present discussion seeks to consider families in their plurality. It is a qualitative study made from an interpretative anthropological point of view. The results indicate that there are accusatory labels, and serious omissions in relation to the configurations of families - underlining the complexity of defining a situation as negligence: families can reproduce, practice, or suffer negligence.

Negligência infantil a partir do Child Neglect Index aplicado no Brasil / Child neglect based on the use of the Child Neglect Index applied in Brazil

Este estudo objetivou descrever a utilização do Child Neglect Index para identificar casos de crianças negligenciadas por seus pais/cuidadores no contexto brasileiro. Após adaptação inicial à realidade sociocultural brasileira, o instrumento foi aplicado em três grupos de indivíduos, cada qual com 30 díades de crianças/pais, totalizando 90 díades (n=180), assim compostos: G1 (primeiro grupo) = casos oficialmente notificados por negligência infantil; G2 (segundo grupo) = casos suspeitos de negligência não notificados; G3 (terceiro grupo) = casos sem suspeita de negligência ou outra forma de maus-tratos (grupo de comparação); além de um quarto grupo de professoras dessas crianças (n=11). Os resultados apontaram altos escores no índice de negligência em G1 e G2, e baixos escores em G3, sugerindo presença de indicadores de falta de supervisão parental referentes a cuidados com alimentação, vestimenta, higiene, saúde física, saúde mental e educação nos dois primeiros grupos avaliados, comparativamente às crianças sem suspeita de maus-tratos. Os atuais achados empíricos, embora preliminares em termos de adaptação do Child Neglect Index ao contexto do Brasil, foram promissores ao sinalizar potencial do instrumento como recurso para detecção/confirmação da negligência infantil, estimulando novas investigações e aprimoramento desse recurso técnico para favorecer adequada identificação e intervenção nesses casos.

This study describes the use of Child Neglect Index to identify cases of children neglected by their parents/caregivers in the Brazilian context. After initial adaptation to the Brazilian sociocultural reality, the instrument was applied in three different groups. Each group is composed of 30 dyads of children/parents, totaling 90 dyads of participants (n=180). They are: G1 (first group) = officially reported cases of child neglect; G2 (second group) = suspected cases of neglect, but not notified; G3 (third group) = unsuspected cases of neglect or otherwise abuse (comparison group). There is also a fourth group composed of the children's teachers (n=11). The results showed high scores on the index of neglect in G1 and G2, but low scores in G3, suggesting the presence of indicators of lack of parental supervision regarding the care of food, clothing, hygiene, physical health, mental health and education in the first two groups evaluated when compared to no suspicion of child maltreatment. The current empirical findings, although preliminary in terms of adaptation of Child Neglect Index to the Brazilian context, were promising to signal the potential of the instrument as a resource for detection/confirmation of child neglect. It stimulates further research and improvements in this technical resource to facilitate proper identification and intervention in these cases.

Negligência infantil a partir do Child Neglect Index aplicado no Brasil / Child neglect based on the use of the Child Neglect Index applied in Brazil

Este estudo objetivou descrever a utilização do Child Neglect Index para identificar casos de crianças negligenciadas por seus pais/cuidadores no contexto brasileiro. Após adaptação inicial à realidade sociocultural brasileira, o instrumento foi aplicado em três grupos de indivíduos, cada qual com 30 díades de crianças/pais, totalizando 90 díades (n=180), assim compostos: G1 (primeiro grupo) = casos oficialmente notificados por negligência infantil; G2 (segundo grupo) = casos suspeitos de negligência não notificados; G3 (terceiro grupo) = casos sem suspeita de negligência ou outra forma de maus-tratos (grupo de comparação); além de um quarto grupo de professoras dessas crianças (n=11). Os resultados apontaram altos escores no índice de negligência em G1 e G2, e baixos escores em G3, sugerindo presença de indicadores de falta de supervisão parental referentes a cuidados com alimentação, vestimenta, higiene, saúde física, saúde mental e educação nos dois primeiros grupos avaliados, comparativamente às crianças sem suspeita de maus-tratos. Os atuais achados empíricos, embora preliminares em termos de adaptação do Child Neglect Index ao contexto do Brasil, foram promissores ao sinalizar potencial do instrumento como recurso para detecção/confirmação da negligência infantil, estimulando novas investigações e aprimoramento desse recurso técnico para favorecer adequada identificação e intervenção nesses casos.(AU)

This study describes the use of Child Neglect Index to identify cases of children neglected by their parents/caregivers in the Brazilian context. After initial adaptation to the Brazilian sociocultural reality, the instrument was applied in three different groups. Each group is composed of 30 dyads of children/parents, totaling 90 dyads of participants (n=180). They are: G1 (first group) = officially reported cases of child neglect; G2 (second group) = suspected cases of neglect, but not notified; G3 (third group) = unsuspected cases of neglect or otherwise abuse (comparison group). There is also a fourth group composed of the children's teachers (n=11). The results showed high scores on the index of neglect in G1 and G2, but low scores in G3, suggesting the presence of indicators of lack of parental supervision regarding the care of food, clothing, hygiene, physical health, mental health and education in the first two groups evaluated when compared to no suspicion of child maltreatment. The current empirical findings, although preliminary in terms of adaptation of Child Neglect Index to the Brazilian context, were promising to signal the potential of the instrument as a resource for detection/confirmation of child neglect. It stimulates further research and improvements in this technical resource to facilitate proper identification and intervention in these cases.(AU)

Afectación de la salud oral en niños que padecen maltrato infantil: reporte de caso / Impact of oral health in children with child abuse: a case report

El maltrato infantil es una patología de la cual se tienen registros desde las civilizaciones antiguas como la griega y egipcia; pero es hasta 1924 que se firma la declaración de Ginebra: Derechos de la infancia, siendo el IX derecho: No al Maltrato. En México se tiene registro de maltrato infantil desde hace 20 años. Se ha tipificado el maltrato infantil en dos grandes rubros: activo y pasivo, la negligencia odontológica es clasificado como maltrato pasivo, por lo tanto el odontólogo (en especial el Odontopediatra) debe prestar atención al hacer la inspección clínica y elaboración de historia clínica del paciente, para encontrar indicios de maltrato infantil y llevar a cabo la atención de estos pacientes con adecuado manejo de su conducta, la cual puede ser variable dependiendo el tipo de maltrato que ha sufrido. Las consecuencias del maltrato en cavidad oral son múltiples y pueden manifestarse a corto, largo y mediano plazo. En este artículo se presenta un caso clínico de maltrato por abandono, negligencia odontológica y las consecuencias que éste tuvo en la salud oral y general de la paciente.

Child abuse is a disease for which there are records from ancient civilizations like the Greek and Egyptian, but until 1924 when the Geneva Declaration was signed: Children's rights: No to Abuse. In Mexico records of child abuse have been kept for the last 20 years. It has classified child abuse into two major categories: active and passive, dental malpractice liability is classified as child abuse therefore the dentist (especially the pediatric dentist) should pay attention to realize a clinical inspection and preparation of patient history, for signs of child abuse, and carry out the care of these patients with adequate management of their behavior, which can vary depending on the type of abuse the child has suffered. The consequences of abuse in oral cavity are multiple and can occur at short, medium and long term. This article presents a case of abuse by dental neglect and the consequences that this has on oral health, and therefore on the general health of the patient.

Maltrato infantil: experiencia multidisciplinaria unidad de salud mental Hospital General Pediátrico Niños de Acosta Ñú / Child abuse: the experience of the multi-disciplinary mental health unit of the Niños de Acosta Ñú General Pediatric Hospital

El Maltrato Infantil ocupa el cuarto lugar en frecuencia de diagnósticos del total de consultas de la Unidad de Salud Mental según un estudio previo realizado en el Hospital General Pediátrico, y le siguen los trastornos del aprendizaje, del estado ánimo y conductuales. Este estudio tiene como objetivo describir las características epidemiológicas, los motivos de consultas más frecuentes y los diagnósticos asociados al maltrato infantil. Se revisaron 1356 fichas clínicas, período Julio 2001-Setiembre 2009. Correspondió al sexo Masculino (45%) Femenino (55%). El grupo de edades mas afectado estuvo entre los 4-14 años (56.5%), las víctimas procedían en su mayoría del Departamento Central (77%). La negligencia o abandono fue el tipo de maltrato más frecuente (51%), seguido del Abuso Sexual (18.3%). Las víctimas fueron maltratadas con mayor frecuencia por ambos padres (38%), padre (16%) y madre (14%); representando un total de (68%). Conocía al agresor en un (99%). Los casos fueron referidos en mayor porcentaje del Consultorio Externo (19%). Consultó por síntomas depresivos (26.8 %); mientras que (8%) por intentos de suicidio y (11, 3%) por violencia intrafamiliar. Los diagnósticos más frecuentes asociados al maltrato infantil fueron los trastornos depresivos (60.5%), seguido de trastornos del comportamiento y de la atención (7.7%). Se concluye que la presencia de trastornos depresivos o síntomas depresivos con o sin intento de suicidio deberían alertar al pediatra a la sospecha de maltrato infantil.

Child abuse is the fourth most commonly diagnosed condition for patients seen at the mental health unit according to a previous study done at the general pediatric hospital, following only learning, mood, and behavior disorders. The objective of our study was to describe the epidemiological characteristics, most frequent motives for consultation, and diagnoses associated with child abuse. We reviewed 1356 medical records covering the period of July 2001 to September 2009, of which 45% were for male and 55% for female patients. The most affected age group were those from ages 4-14 years (56.5%), with most victims (77%) being from the country's Central Department. Negligence or abandonment were the most common types of abuse (51%), followed by sexual abuse (18.3%). Victims were mistreated in a plurality of cases (38%) by both parents, by the father alone in 16% and by the mother alone in 14%, with these categories jointly making up 68% of the total cases. In 99% of cases the child knew the abuser. A plurality of cases (19%) were referred for treatment by the institution's own outpatient clinic. Of all cases examined, 26.8% consulted for symptoms of depression, while attempted suicide motivated 8% of consultations, and domestic violence 11.3%. Diagnoses most commonly associated with child abuse were depressive disorders (60.5%), followed by behavior or attention deficit disorders (7.7%). It is concluded that the presence of depressive disorders or symptoms with or without suicide attempts should alert the pediatrician to suspect child abuse.