Maria Monaco spent the last 18 years of her life locked in a bare room in a sleepy southern town, fed in tin bowls and watched over by her elderly mother and siblings as she slept in a filthy bed.
Investigators and experts say the case of the woman imprisoned in her family's home in Santa Maria Capua Vetere, near Naples, is only the most recent example of a widespread stigma attached to mental and physical disability in many poor areas of Italy.
Monaco, now 47, had a history of psychiatric problems when her family decided to lock her up, allegedly because she had become pregnant out of wedlock, investigators say.
When police were brought in last week after a neighbor called to protest about the smell rising from the apartment, they found the woman in the room with a bed with soiled sheets, a filthy toilet and sink, as well as plastic bottles of water and a metal dog bowl used to feed her.
Police arrested Monaco's brother, a farmhand, and sister, who worked in a nursery school, and put her ailing, widowed, 80-year-old mother under house arrest. They are being investigated on suspicion of mistreatment and kidnapping.
Monaco's now 17-year-old son grew up with relatives and knew she was his mother, though he was told that she was too sick for visits, said prosecutor Antonio Ricci. The same was told to inquisitive neighbors or distant relatives.
The Italian media have compared Monaco's segregation to other abuse stories that have surfaced recently in Austria, including the case of Elisabeth Fritzl - who had seven children from her father and was held captive underground for 24 years in the family's home west of Vienna - and of Natascha Kampusch, the Austrian girl abducted at age 10 and held in an underground cell for eight-and-a-half years by her kidnapper.
But far from being an isolated abuse case, Monaco's fate is shared by some in rural parts of Italy, where a mix of embarrassment and ignorance pushes families to segregate relatives who have mental or physical disabilities, Ricci said.
"This is a particularly horrible case," the prosecutor said. "But this measure is often taken with the mentally ill, also because there is little access to healthcare in the most isolated areas."