Peer-reviewed article
Clinical profiles and hospitalization patterns among abused children referred by Child Guidance Centers in Japan.
Furuhashi K ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined 84 children referred to psychiatry services by Child Guidance Centers in Japan between 2019 and 2023 to understand patterns of abuse and hospitalization. Psychological abuse was most common, affecting 80% of children, followed by physical abuse, neglect, and sexual abuse. Girls were more likely to experience sexual abuse and be hospitalized, while children with neurodevelopmental disorders had lower recorded rates of sexual abuse, suggesting possible under-recognition.
Key points
- Psychological abuse was the most prevalent form (80%), followed by physical abuse (70%), neglect (35%), and sexual abuse (33%)
- Girls had 6.16 times higher odds of experiencing sexual abuse compared to boys
- Children with neurodevelopmental disorders had significantly lower recorded rates of sexual abuse (OR 0.29), indicating potential under-recognition
- Hospitalization was associated with experiencing multiple types of abuse and with sexual abuse by non-caregivers (OR 4.53)
- The cumulative burden of maltreatment was high among referred children
Limitations
This is a retrospective observational study of children already referred to psychiatric services through one system in Japan, so it cannot determine causation or generalize to all abused children. The lower recorded prevalence of sexual abuse among children with neurodevelopmental disorders may reflect under-recognition rather than true differences in prevalence.
Abstract
BACKGROUND: Child Guidance Centers (CGCs) play a central role in child protection in Japan, yet evidence on abused children referred to psychiatric services remains limited. METHODS: We retrospectively reviewed 84 children referred by CGCs (2019–2023) to a child and adolescent psychiatry department. Demographics, types of abuse, neurodevelopmental disorders (NDs), prior psychiatric care, hospitalization, and experiences of sexual violence by non-caregivers were extracted from medical records and CGC referral forms. Fisher’s exact test, Pearson’s chi-square test, and the Wilcoxon rank-sum test were used, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS: Psychological abuse was most prevalent (80%), followed by physical (70%), neglect (35%), and sexual abuse (33%). Girls had higher odds of sexual abuse (OR 6.16, 95% CI 1.32–28.8) and were more frequently hospitalized. Children with NDs were less likely to have sexual abuse recorded (OR 0.29, 95% CI 0.10–0.83). Hospitalization was associated with experiencing a greater number of abuse types and with sexual abuse (OR 4.23, 95% CI 1.49–12.00), particularly when perpetrated by non-caregivers (OR 4.53, 95% CI 1.51–13.60). CONCLUSIONS: Among CGC-referred children receiving psychiatric care, notable patterns included gender differences in abuse profiles, a high cumulative burden of maltreatment, and a lower recorded prevalence of sexual abuse among those with NDs. These findings highlight the need for careful clinical assessment and coordinated, ND-sensitive approaches that reduce under-recognition. Although derived from a CGC-based referral system, the results may inform efforts to integrate child protection and child and adolescent mental health services internationally.