• “The real world will always be superior to the virtual one,” says psychologist Marc Masip
• “ADHD is one of the most common causes of academic failure in adolescence,” said psychiatrist Mara Perallada
• “It is harder to mend a broken adult than to bring up a child with ADHD,” Perallada acknowledged

“The real world will always be superior to the virtual world,” emphasised psychologist Marc Masip from Barcelona at the conference held at the Provincial Mental Health Hospital in Bétera, organised by the Fundación Valenciana Premios Rei Jaume I to discuss mental health in childhood.

Alongside Masip, psychiatrist Mara Perallada spoke about Attention Deficit Hyperactivity Disorder (ADHD) and its evolution over time and in medical practice, referring to it as “a blindness to time, which prevents them from having that internal clock to know how time passes”. The psychiatrist also spoke about ASD, or Autism Spectrum Disorder, to an audience of over a hundred people, mostly medical students, who attended the event.

Marc Masip, a child psychologist and CEO and founder of Desconecta, which has centres in Barcelona, Madrid and Málaga, spoke about the importance of ICT (Information and Communication Technologies) in children’s mental health. Under the title ‘The Heroine of the 21st Century’, the psychologist shared statistics such as ‘61 per cent of teenagers play video games’ and ‘chatting is most common at night’, and emphasised that “the more knowledge I have, the more freedom I have to choose”, and led a series of games and interactive activities with the large audience in attendance—mostly medical students—which carried a final message: “knowledge leads to freedom, but if freedom is granted without knowledge, it is very likely to end in addiction”.

The warning signs to help determine whether or not a person is addicted to their mobile phone are clear: “spending a lot of time in their room, emotional changes, poor academic performance, and becoming angry or moody when their use of new technologies is restricted”, and the consequence of all this is “gradual isolation from the real world”.

Masip drew attention to the complex situation facing our society today, stating, “We are experiencing the highest suicide rate of all time,” and highlighted situations that lead to children being exposed to pornography at far too early an age, “which nowadays enters children’s lives from as young as eight years old”.

“Without a real presence or an inner connection, values are mere words,” he summarised in conclusion, recommending that people spend no more than two hours in front of a mobile phone and advising on the appropriate age to start using one: “We shouldn’t give our children mobile phones before the age of 16, nor should we let them use social media; the real world will always be superior to the virtual one,” he emphasised in closing.

For her part, Mara Perallada, from the psychiatry department at Gregorio Marañón Hospital, as well as vice-president of the Spanish Association of Child and Adolescent Psychiatry and of the Department of Psychiatry at the Complutense University of Madrid, addressed two topics: ADHD and ASD. 

 “ADHD involves hyperactivity, impulsivity and attention deficit or executive dysfunction,” he stated. “It is an attention deficit that is out of proportion to the rest of their abilities. Inattention, poor concentration, poor planning, and an inability to rectify or resolve certain issues. It is chronic and has been embedded in the brain’s memory system since childhood, but he pointed out that ‘one must always rule out the possibility that it is caused by another medical condition (deafness, blindness, etc.)’.”

The specialist from Gregorio Marañón pointed out that “psychiatric disorders are not illnesses that manifest in a uniform way, as they can change over time. Over time, it has become clear that adults also suffer from this disorder, although many improve”, and she advised that “children with ADHD would be better off engaging in active pursuits in their daily lives.”

By age, he categorised cases of children with this disorder, starting from nursery school, where “you often see very restless, energetic children who never seem to tire; they are disorganised, frustrate their teachers, and never finish anything they start; they are impulsive, constantly interrupting and acting rashly”.

After nursery school, “in primary school, many children arrive without a diagnosis and display frequent lapses in attention, tantrums and aggression. And in adolescence, it is one of the most common causes of academic failure,” the psychiatrist pointed out. “And yet it is many psychiatrists’ favourite condition, as it is rewarding because it can respond very well to treatment, provided you know how to deal with it and don’t accuse them of being lazy, don’t stop them from getting up, or tie them down; ultimately, they choose career paths and give up on further education. These are young people with low self-esteem. And when it comes to diagnosis, a positive diagnosis is crucial,” she emphasised.

The vice-president of the Spanish Psychiatric Association rejected the use of quick questionnaires to diagnose ADHD, “which never detect a learning difficulty nor take other mental health conditions into account”.

He listed the most common problems, in addition to poor academic performance, “such as the fact that they tend to visit A&E more frequently. In the short term, the best approach is medication combined with contextual factors that help them build confidence.” In conclusion, he emphasised “the need for a personalised approach” whilst also warning of “a serious risk of falling into drug abuse.”

In terms of figures, he stated that “15 per cent still have symptoms at the age of 25, 50 per cent experience partial remission by the age of 25, and the prevalence in adults is between 2 and 4 per cent. “Furthermore,” she continued, “the neurobiological problem overlaps with other neurodevelopmental issues.” Parental hostility or criticism and not belonging to a peer group are the most significant factors in children with ADHD when they reach adolescence. However, the psychiatrist advocated providing these patients with “education, a healthy childhood, good communication skills and ensuring they have high self-esteem, as well as learning to love them, appreciate them and get to know them as individuals, because they tend to work well with young children; we should ask less of them, but helping them to take responsibility”, citing Michael Phelps and the Renaissance master Leonardo da Vinci—both of whom were resilient children—as examples of famous people with ADHD. “It is harder to repair a broken adult than to bring up a child with ADHD,” she concluded.

Mara Perallada also spoke about Autism Spectrum Disorder (ASD), in which she specialises, and described it as “having difficulty understanding how the world works. A neurodevelopmental disorder or a ‘blindness’ to one’s surroundings.” “For them,” she said, “the world of people is no different from the world of things.”

The doctor described this condition as one characterised by “significant difficulties with non-verbal communication: gestures, intentions… and difficulties in forming relationships. “They are inflexible, with an inability to adapt; they suffer from anxiety, rigidity and an insistence on ‘sameness’ – that things must be exactly as they have always known them to be,” she explained to the large audience in attendance. For Dr Perallada, “autism begins before birth. And that is why it is essential that the National Health Service covers the cost of genetic testing. Genetic factors are fundamental, leading us towards precision medicine, which will be essential in the future,” she argued.

“Comorbidities can be the greatest source of disability: anxiety or depression, or the language delays that people often experience. And it is these comorbidities that are most commonly treated in consultations,” he said.

“But what worries families with children with autism the most,” said Perallada, “are communication problems, knowing what they do and do not need, and depression and anxiety – far more than social reciprocity. For people with autism who want to interact with others, this is their greatest concern,” according to a study by the American society.

The event began with a welcome address by Alfredo Ribelles, director of the Provincial Mental Health Hospital in Bétera, who expressed his gratitude for the large turnout, comprising mainly students from the Faculty of Medicine in Valencia. She was followed by Elia Verdevío, Mayor of Bétera, who described the event as “an occasion that allows us to pause and reflect”.  Jose Vte. Guillem, speaking on behalf of the executive chairman, Javier Quesada, expressed his gratitude and recognised the importance of events such as these “in which the Foundation gets involved in social initiatives to help society”. and Inma González, from the Valencia Provincial Council, spoke of this event “as a challenge for mental health in this century, with a commitment and willingness to tackle all the challenges that arise in order to achieve a better quality of life for all citizens”.

Francisco Bueno, co-director of this series of lectures, introduced the two speakers and argued that “learning should guide students in their work, rather than in the here and now”. Bueno emphasised the need for a range of perspectives to tackle this sort of problem and highlighted “the family, the very essence of education, which is so reviled nowadays”.

If you’d like to watch part of the recording of the day’s events: