1 research outputs found
Child Abuse and Neglect Associated With Parental Paranoid Psychotic Disorder
After attending this presentation, attendees will better understand the importance of deep-rooted childhood
experiences in patients with paranoia and psychosis in order to stop the vertical chain of transmission of child abuse
and neglect.
This presentation will impact the forensic science community by highlighting how parental psychotic disorders
and psychosocial deprivation within the home can result in disturbances of the growth and development of children.
This case study demonstrates that rickets can occur from not only genetic or organic causes, but can also be the
result of severe child abuse/neglect and poor nutritional status.
An 18-month-old child was hospitalized at the Ospedale Infantile Regina Margherita in Turin, Italy, and
examined by staff of the operative unit dedicated to the evaluation of suspected child abuse (Bambi). The male
child presented in poor condition with length in the third percentile, weight less than the third percentile, bossing
of the forehead, caput quadratum, flared chest, rachitic rosary, widening of wrists, bowed legs, double malleoli,
delayed eruption of teeth with enamel hypoplasia, thoracolumbar kyphosis, difficulty in sitting, an inability to walk,
and generalized dystrophy. The X-ray and blood tests confirmed the diagnosis of “severe deficiency rickets and
poor weight gain resulting in motor delay.” A few days later, the child’s 2-month-old brother was hospitalized for
“poor growth and nutritional status under the normal range.” He was generally in poor condition with a growth
curve between the 25th and 50th percentile and exhibited sparse subcutaneous fat, a protruding abdomen, and had a
poor sucking reflex. The children were two of five sons (the oldest was five years old) of an architect and his wife
of Somali origins, residing in Turin for a couple of years. The family was followed for approximately a year by
social services because, when the fourth child was one month old, neighbors filed a complaint with the authorities,
reporting that the children were tied to radiators. The children had never been visited by a pediatrician. None of
them attended nursery school. Hospitalization occurred after a home visit when the pediatric nurse reported that
the house was dark and highly malodorous, with shutters closed by chains. The children were playing in small
dirty boxes. The mother, by means of a cultural mediator, explained that the 18-month-old child was fed only
bread soaked in milk, while the younger brother was fed with cow’s milk diluted with water. The third child was
underweight because the two older brothers also ate his food. The father was affected for years by a severe form
of “paranoid psychotic disorder,” usually well compensated by antipsychotic therapy. He convinced his wife,
who was extremely dependent on him, that Italy was a dangerous country, with shortages of food and poor health
services, and that the children could throw themselves out of the windows if they were not closed. Family history
also included a psychiatric disorder of the children’s paternal grandmother.
Accumulated evidence consistently demonstrates a relationship between childhood adversity and psychosis
in adulthood. Meta-analyses have confirmed that a wide range of adverse experiences in childhood is associated
with psychosis.1
In particular, there is evidence of specific association between insecure attachment/neglect and
the development of a paranoid disorder.2
The fact that the paternal grandmother was suffering from a psychiatric
condition may have resulted in her son growing up with poor emotional attachments. The situation may have
1136 *Presenting Author
contributed to the development of psychotic-paranoid symptoms, subsequently exacerbated by the transfer to a big
city in another country where the family was devoid of social relationships.
Reference(s):
1. Fisher H.L., Appiah-Kusi E., Grant C. Anxiety and negative self-schemas mediate the association between
childhood maltreatment and paranoia. Psychiatry Research. 196 (2012) 323-324.
2. Sitko .K, Bentall R.P., Shevlin M., O’Sullivan N., Sellwood W. Associations between specific psychotic
symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National
Comorbidity Survey. Psychiatry Research. 217 (2014) 202-209.
Child Neglect, Paranoid Disorder, Psychosocial Deprivatio