[Are we really detecting violence in families of children visiting our health services? The experience of a public health service in Rio de Janeiro, Brazil].

Domestic violence, particularly in childhood, is a growing public health concern. Information on morbidity is mostly underreported due to constraints in case detection. This paper analyzes the frequency of events measured actively by outpatient services as compared to spontaneous reports. Information on violence was assessed for 245 families from April to June 2001 using the Conflict Tactics Scales: Parent-Child Version (CTSPC) and the Revised Conflict Tactics Scales (CTS2). Cases referred to the Social Work Department provided the caseload for the active search period (12 months). There was a high prevalence of physical violence in the couple, with serious events occurring in 17.0% of the families. In relation to children, cases of "minor" physical aggression were reported in 46.0% of families and serious cases in 9.9%. The spontaneously identified prevalence was 3.3%. This case study demonstrates the missed opportunities for detection and calls attention to the need to review the approach to domestic violence by health services.