Co-producing research on psychosis: a scoping review on barriers, facilitators and outcomes.

INTRODUCTION: Co-production is a collaborative approach to service user involvement in which users and researchers share power and responsibility in the research process. Although previous reviews have investigated co-production in mental health research, these do not typically focus on psychosis or severe mental health conditions. Meanwhile, people with psychosis may be under-represented in co-production efforts. This scoping review aims to explore the peer-reviewed literature to better understand the processes and terminology employed, as well as the barriers, facilitators, and outcomes of co-production in psychosis research. METHODS: Three databases were searched (MEDLINE, EMBASE, PsycINFO) using terms and headings related to psychosis and co-production. All titles, abstracts and full texts were independently double-screened. Disagreements were resolved by consensus. Original research articles reporting on processes and methods of co-production involving adults with psychosis as well as barriers, facilitators, and/or outcomes of co-production were included. Data was extracted using a standardised template and synthesised narratively. Joanna Briggs Institute and the AGREE Reporting Checklist were used for quality assessment. RESULTS: The search returned 1243 references. Fifteen studies were included: five qualitative, two cross-sectional, and eight descriptive studies. Most studies took place in the UK, and all reported user involvement in the research process; however, the amount and methods of involvement varied greatly. Although all studies were required to satisfy INVOLVE (2018) principles of co-production to be included, seven were missing several of the key features of co-production and often used different terms to describe their collaborative approaches. Commonly reported outcomes included improvements in mutual engagement as well as depth of understanding and exploration. Key barriers were power differentials between researchers and service users and stigma. Key facilitators were stakeholder buy-in and effective communication. CONCLUSIONS: The methodology, terminology and quality of the studies varied considerably; meanwhile, over-representation of UK studies suggests there may be even more heterogeneity in the global literature not captured by our review. This study makes recommendations for encouraging co-production and improving the reporting of co-produced research, while also identifying several limitations that could be improved upon for a more comprehensive review of the literature.

Autistic disorder in Nigeria: profile and challenges to management.

Autism represents one of the most common developmental disorders affecting children, but there are few reports on autism in African children. Our study describes the profile of autistic disorder in a cohort of Nigerian children and appraises short-term outcomes. Children seen at the pediatric neurology and the child psychiatry clinic of the University College Hospital, Nigeria were screened for autistic disorder using the American Psychiatric Association's Diagnostic and Statistical Manual IV. Forty-five males and 9 females were identified with autism, and the disease accounted for 2.3% of 2320 new cases seen during the period. The mean age at which parents observed deviations in behavior was 22.5 (SD=6.6) months, while the mean age at diagnosis was 44.7 (SD=21.2) months. Twelve (22.6%) children had a positive family history of autism, and forty (75.5%) had associated neurological comorbidities. Diagnosis of autism is often delayed in Nigeria, and affected children have a high frequency of neurological comorbidities.

Neurological and intellectual disabilities among adolescents within a custodial institution in South-West Nigeria.

A total of 67 adolescents from a juvenile remand home were matched with 67 other adolescents by age and gender, with a view to determine the prevalence and spectrum of neurological and intellectual disabilities. Intelligence quotient (IQ) was estimated using an adapted version of the Slosson's Intelligence Test and a full neurological evaluation was carried out. The mean IQ score for the remand home participants was significantly lower than the controls (77 ± 11 vs. 99 ± 14; t = 1.6, P = 0.001). Almost half (46.7%) of the participants in the remand home had intellectual disability of varying degrees, including borderline intellectual functioning, compared with only two (3.3%) of the comparison group (P < 0.001). Epilepsy and neurological deficits were significantly more prevalent among the remand home group, particularly those admitted as victims of neglect, compared with the comparison group (P ≤ 0.02). These findings and recent literature were used to speculate the possible underlying factors. Policy implications for child social welfare in Nigeria were suggested.

Mental health problems in Nigerian children with epilepsy: associations and risk factors.

Epilepsy is the most common neurological disorder affecting children, and the greatest burden of childhood epilepsy is found in the developing countries of the world. Behavioral problems are reported to occur more frequently in children with epilepsy, but there are limited studies on the pattern of behavioral problems in children living with epilepsy in sub-Saharan Africa. Eighty-four consecutive cases of epilepsy aged ≥5 years seen at the pediatric neurology clinic of the University College Hospital, Ibadan, Nigeria over a period of 9 months were screened for behavioral problems using the Rutter A2 scale. Behavioral problems were found in 39 (46.6%) of 84 subjects and occurred more frequently in males. Presence of associated learning difficulties (OR 5.13, 95% CI 1.61-16.36) and being diagnosed with epilepsy within 6 months of the onset of the first epileptic seizure (OR 4.54, 95% CI 0.073-0.69) independently predicted psychopathology in the cases studied. Emotional and behavioral problems are common in Nigerian children with epilepsy. There is a need for effective mental health services for children with epilepsy in order to optimize outcomes.