My name is Leonor Asensio Aguerri, I am a doctor specialising in psychiatry. I studied medicine at the University of Seville, and later completed my psychiatry residency at the Reina Sofia Hospital in Cordoba.
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During my training as an Internal Medical Resident (MIR), in addition to the stipulated rotations, I carried out an external rotation in the “Early Care Unit for Mental Illness” at the University Hospital of Heidelberg (Germany), belonging to the Child and Adolescent Mental Health Service. Subsequently, I also did an external rotation at the Neuropaediatric Service of the Reina Sofia Hospital.
After completing my specialisation, I have worked in different hospitals: Hospital Son Llatzer, in Palma de Mallorca; Hospital de media estancia de Usurbil (San Sebastián); Hospital Universitario de Ciudad Real and Hospital Juan Ramón Jiménez (Huelva). I am currently working at the Hospital Vírgen del Rocío, specifically in the Juvenile Children’s Mental Health Unit (USMIJ).
During all these years, I have continued training, doing Masters, expert courses, different training courses and I have completed my doctoral thesis at the University of Castilla La Mancha, entitled “Paranoid thinking and well-being. The role of doubt in pharmacological and metacognitive therapies”. I have also contributed to scientific dissemination through different scientific articles, book chapters, communications in conferences, and as a teacher in different courses.
1. What is the role of the psychiatrist in general?
Psychiatrists are medical specialists who are in charge of diagnosing, preventing and treating mental illnesses. To do this, it is necessary to make a differential diagnosis of what is happening to the patient, and then assess the best treatment. Depending on the device in which we work, the therapeutic objectives will be different, always adapted to what the patient needs at any given moment.
We normally form part of a team, through which a multidisciplinary treatment is carried out. At the USMIJ, we work together as a team made up of psychiatrists, clinical psychologists, nurses, nursing assistants, occupational therapists, a social worker and a teacher-therapist. I consider this fundamental in order to be able to deal with the difficulties that patients present in the different areas.
In addition to the day-to-day work in the relevant unit, we also carry out on-call duty in the emergency department and in the inpatient unit.
2. What is your experience in treating children or people with ASD?
At the USMIJ we currently have a protocol for the diagnosis and approach to patients with ASD. We assess the patients, and in coordination we carry out the diagnosis, as well as the assessment of possible comorbidities and the need for treatment. Some of the objectives of this protocol are to promote early care, improve the quality of care for both patients and their families, promote the study and early diagnosis, know specifically and objectively the needs of children and their families, objectively identify the most complex cases, implement interventions to detect and prevent situations of abuse in a vulnerable population, as well as improve the accessibility of children with ASD to health services and promote the development of research projects that improve knowledge and thus the approach to patients.
The USMIJ currently treats children aged 2 to 6 years with a suspected or confirmed diagnosis of ASD and all children aged 0 to 18 years with a diagnosis of ASD and comorbidities that are difficult to manage. Among the most frequent comorbidities, present in 72% of ASD patients, are the following:
- 42% Anxiety.
- 31% ADHD.
- 10% Depressive disorders.
- 11% Tics.
- 4% Conduct disorders.
- 2% Psychotic symptoms (In high-functioning ASD in adolescence and adulthood, the appearance of non-specific psychotic symptoms is frequent.)
- 4% Eating disorders.
In those with more preserved cognitive and social abilities, anxiety/depression disorders are more frequent throughout life. To carry out this protocol, as mentioned above, we work together with the multidisciplinary team.
3. What pathologies do you most frequently encounter in paediatric consultations and how do you deal with them? Any that are of particular interest to you?
In your case, you can focus on AED or the pathology of your choice.
Currently, due to the situation we are living in, there has been a significant increase in the number of consultations in Child and Adolescent Mental Health. We treat all types of pathologies related to mental health that occur in children and young people up to the age of 18. Unfortunately, we have seen a significant increase in patients with depressive symptoms, anxiety, emotional instability, suicide attempts, self-harm and eating disorders.
In my case, another of the protocols in which I actively participate is the “Protocol for early intervention in first psychotic episodes“. The first symptoms of psychosis usually start in childhood or adolescence. Early detection is very important, as well as the correct treatment of these symptoms, in order to reduce the impact on the person’s quality of life and level of functionality.
4. Any recommendations to improve the prevention of injuries in children when they reach adulthood?
In this regard, at the Mental Health level, I believe that early detection and treatment of the symptoms presented by the patient is important. I think we need to focus on eliminating the stigma in Mental Health, and educate the population on when to ask for help and where to ask for it.
