Evaluation of sexual abuse cases: 12 years of child protection unit experience

Child abuse (CSA) is a significant public health concern with profound psychiatric and social consequences. This incidence-based study reports 12 years of CSA cases evaluated at a hospital-based Child Protection Center in Türkiye.

This retrospective cross-sectional study included 569 children (<18 years) assessed between 2011 and 2022. Data was obtained from forensic interviews, medical files, and psychiatric evaluations. Group differences were compared by sex, age, and incest status. Multivariable analyses identified predictors of incest and penetration.

The mean age was 10.9 ± 3.9 years; 75.0% were girls. Boys were younger and more often exposed to penetration, whereas girls more frequently showed delayed disclosure, self-harm, and suicidality. Incest (22.4%) was linked with younger age, parental separation, repeated abuse, and family denial. Regression models showed that younger age, female sex, and parental separation independently predicted incest; odds ratios <1 reflected higher likelihood among these groups due to reference categories (older age, boys, intact families). Penetration was more common in older children (Odds Ratio [OR] =1.15, p < 0.001), girls (OR = 3.29, p < 0.001).

CSA patterns are closely shaped by demographic and familial vulnerabilities. Younger children, girls, and those from separated families represent high-risk groups for incest or severe abuse. Strengthening routine screening in schools, primary care, and mental health services, together with family-focused interventions within Child Protection Centers, may enhance early detection and improve outcomes.