{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T06:51:43Z","timestamp":1772866303625,"version":"3.50.1"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>Child abuse (CA) remains a significant public health concern, where distinguishing between accidental and intentional injury is particularly difficult in complex cases involving underlying medical conditions. We present a disturbing case study of severe abuse and neglect to illustrate the necessity of a systematic and evidence-based approach to forensic evaluation. The case featured a complex clinical picture: multiple bone fractures in a child with Infantile Epileptic Spasms Syndrome (West Syndrome), under treatment with valproic acid, and evidence of cocaine exposure. A systematic diagnostic work-up, structured according to authoritative international protocols, was conducted, including detailed medical history, physical examination, imaging, toxicological, and genetic analyses. Despite these compounding challenges, a careful clinical evaluation and critical review of international guidelines led to a definitive diagnosis of child abuse and neglect. This work represents a valuable educational resource for healthcare professionals and underscores the significance of implementing systematic protocols for assessing child maltreatment.<\/jats:p>","DOI":"10.3389\/fpsyt.2026.1631508","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T10:12:36Z","timestamp":1771495956000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case report: A systematic approach for the forensic evaluation of child abuse: lessons from a complex case"],"prefix":"10.3389","volume":"17","author":[{"given":"Pierpaolo","family":"Di Lorenzo","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II","place":["Naples, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Capasso","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II","place":["Naples, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Sammarco","sequence":"additional","affiliation":[{"name":"Legal Medicine Unit, ASL Roma 6","place":["Rome, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Pieri","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II","place":["Naples, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Casella","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II","place":["Naples, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.36131\/cnfioritieditore20230201","article-title":"Child maltreatment, abuse, and neglect: an umbrella review of their prevalence and definitions","volume":"20","author":"Massullo","year":"2023","journal-title":"Clin Neuropsychiatry"},{"key":"B2","unstructured":"Child maltreatment"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.06.020","article-title":"Barriers and facilitators to detecting child abuse and neglect in general emergency departments","volume":"66","author":"Tiyyagura","year":"2015","journal-title":"Ann Emergency Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e20200438","DOI":"10.1542\/peds.2020-0438","article-title":"Long-term cognitive, psychological, and health outcomes associated with child abuse and neglect","volume":"146","author":"Strathearn","year":"2020","journal-title":"Pediatrics"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e1001349","DOI":"10.1371\/journal.pmed.1001349","article-title":"The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis","volume":"9","author":"Norman","year":"2012","journal-title":"PloS Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1176\/appi.ajp.2019.19010020","article-title":"The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders","volume":"177","author":"Lippard","year":"2020","journal-title":"AJP"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.186","article-title":"Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders","volume":"67","author":"Green","year":"2010","journal-title":"Arch Gen Psychiatry"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12713","article-title":"Annual Research Review: Childhood maltreatment, latent vulnerability and the shift to preventative psychiatry - 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