Publications
31 results found
Ogundele M, Ayyash HF, Ani C, 2022, The impact of Covid-19 pandemic on services for children and adolescents with ADHD: results from a survey of paediatricians in the United Kingdom, AIMS Public Health, Vol: 9, Pages: 542-551, ISSN: 2327-8994
Background:The Covid-19 pandemic has led to huge disruptions and multi-domain healthcare crisis, with additional impact on children and young people (CYP) affected by Attention Deficit and Hyperactivity Disorder (ADHD).Methods:We conducted an online survey and obtained responses from 62 Paediatricians who provide ADHD services for CYP about their experience of Service disruption and adaptations during the first Covid-19 lockdown in the United Kingdom between March and June 2020. The responses were both quantitative and qualitative.Results:The Paediatricians reported huge service disruptions such that almost half ceased the assessment of new patients with ADHD, and only 5% were able to offer physical monitoring for most patients. However, all respondents had adopted telemedicine, which allowed them to maintain high levels of non-physical service provision for existing patients. The Paediatricians used risk stratification strategies to determine which patients were more likely to benefit from the limited available face to face appointments for physical monitoring. The Paediatricians demonstrated clinical pragmatism to meet the needs of their patients such as starting medication without physical exam especially if the patient's behaviour was so challenging that it was presenting a crisis at home, and setting aside monthly limits for stimulant medications. Some respondents reported helpful cross-service collaborations to support CYP with ADHD and their families.Conclusion:The Covid-19 pandemic has had adverse effect on many CYP with ADHD and caused huge disruption to the ADHD services that support them. As the pandemic continues to cause disruptions to ADHD services, the service adaptations emerging from the literature including some of those identified in this study could be useful to support more stable and sustainable ADHD services, both during and after the pandemic.
Ani C, Ayyash H, Ogundele M, 2022, Community paediatricians’ experience of joint working with Child and Adolescent Mental Health Services: Findings from a British National Survey, BMJ Paediatrics Open, Vol: 6, Pages: 1-10, ISSN: 2399-9772
Objectives:Children and young people (CYP) presenting to Paediatric or Child and Adolescent Mental Health Services (CAMHS) often have needs spanning medical and psychiatric diagnoses. However, joint working between Paediatrics and CAMHS remains limited. We surveyed community paediatricians in United Kingdom (UK) to inform better strategies to improve joint-working with CAMHS.Methods:We conducted an online survey of community paediatricians through the British Association of Community Child Health (BACCH) on how much joint working they experienced with CAMHS, any hindrances to more collaborative working, and the impact on service users and service provision. This paper is based on thematic analysis of 327 free text comments by the paediatricians. Results:A total of 245 community paediatricians responded to the survey (22% of BACCH members). However, some responses were made on behalf of teams rather than for individual paediatricians. The key themes identified were: a strong support for joint working between Community Paediatrics and CAMHS; an acknowledgement that current levels of joint working were limited; the main barriers to joint working were splintered commissioning and service structures (e.g. where Integrated Care Systems {ICSs} fund different providers to meet overlapping children’s health needs); and the most commonly reported negative impact of non-join working was severely limited access to CAMHS for CYP judged by paediatricians to require mental health support, particularly those with autism spectrum disorder (ASD).Conclusion:There is very limited joint working between Community Paediatrics and CAMHS in the UK, which is associated with many adverse impacts on service users and providers. A pro-integration strategy that includes joint commissioning of adequately funded Paediatric and CAMHS services that are co-located and within the same health management organisations - is crucial for improving joint-working between Paediatrics and CAMHS.
Mitchell RHB, Ani C, Cyr C, et al., 2021, Near-Fatal Self-Harm Among Canadian Adolescents, CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, Vol: 67, Pages: 598-607, ISSN: 0706-7437
Ani C, 2021, Editorial: New insights into self-harm among children and young people - renewed links with inequality, new opportunities for recognition and new treatment option, CHILD AND ADOLESCENT MENTAL HEALTH, Vol: 26, Pages: 301-302, ISSN: 1475-357X
Egbegi R, Bella-Awusah T, Omigbodun O, et al., 2021, A controlled trial of Cognitive Behavioural Therapy-based strategies for insomnia among in-school adolescents in southern Nigeria, Child and Adolescent Psychiatry and Mental Health, Vol: 15, ISSN: 1753-2000
Background:Sleep difficulties are highly prevalent among adolescents, and are associated with significant impairments. The effectiveness and acceptability of Cognitive Behavioural Therapy-based (CBT-based) treatment for insomnia in adolescents is established for High Income Countries, but unknown for African settings. Thus, the aim of this study was to assess the effect of CBT-based intervention among in-school adolescents with sleep difficulties in Southern Nigeria.Methods:This was a pilot controlled trial involving 50 adolescents with highest ranked scores on the Insomnia Severity Index (ISI) recruited from four schools (two government and two privately owned). Balloting was used to assign two schools (public and private) with 25 participants to the intervention group, and the other two schools (public and private) with 25 participants as waiting-list controls. The two groups were dyad-matched for baseline ISI scores, gender, and type of school to reduce baseline differences. The treatment group received weekly group-based manualised CBT-based intervention over 5 weeks. Primary outcome was ISI score at 6th week. Secondary outcomes were sleep onset latency (SOL), Total sleep duration (TSD), depressive symptoms, sleep hygiene, and knowledge about sleep.Results:Participants were aged 13–17 years (M = 14.9, SD = 1.16) and consisted of 18 males and 32 females. Controlling for baseline scores, the intervention group showed significantly lower post-intervention insomnia scores compared with the control group {F (1, 34) = 1.10, p = 0.0001, (ηp2 = 0.59}, shorter SOL {F (1, 33) = 1.41, p = 0.0001, ηp2 = 0.39}, longer TSD {F (1, 33) = 1.03, p = 0.0001, ηp2 = 0.47}, lower depressive symptoms {F (1, 31) = 1.32, p = 0.002 (ηp2 = 0.34}, higher knowledge of sleep {F
Ayodeji E, Dubicka B, Abuah O, et al., 2021, Editorial: Mental health needs of children and young people of Black ethnicity.(1) Is it time to reconceptualise racism as a traumatic experience?, CHILD AND ADOLESCENT MENTAL HEALTH, Vol: 26, Pages: 265-266, ISSN: 1475-357X
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- Citations: 3
Oyekunle O, Bella-Awusah T, Ayede A, et al., 2021, Effect of a brief supportive and educational intervention on the psychological well-being of mothers with babies in neonatal wards of a Tertiary Hospital in Ibadan, Nigeria, Journal of Tropical Pediatrics, Vol: 67, ISSN: 0142-6338
OBJECTIVE:To assess the effect of a supportive educational intervention on the psychological wellbeing of mothers whose babies were admitted to Neonatal Care Unit (NCU) in Nigeria.METHODS:Controlled trial involving 41 mothers whose babies were consecutively admitted into two NCUs (21 in the intervention group and 19 controls). The intervention group received two group-based sessions which included psychological coping strategies, and familiarity with NCU environment, equipment, personnel and procedures. The control group received usual care. Outcome measures were depressive symptoms (Edinburg Postnatal Depression Scale—EPDS), stress-related to NCU (Parental Stressor Scale: Neonatal Intensive Care Unit—PSS: NICU) and post-traumatic symptoms (Impact Event Scale-Revised—IES-R).RESULTS:Difference-in-Differences (DiD) analysis showed a difference of −4.70 in PSS: NICU score in favour of the intervention group which was statistically significant [F(3, 75) = 9.47, p < 0.0001, R2 = 0.28]. The differences in EPDS (0.91) and IES-R (2.55) were not statistically significant [F(3, 75) = 10.10, p = 0.74] and [F(3, 75) = 10.13, p = 0.73], respectively. All the mothers in the treatment group expressed satisfaction with the intervention.CONCLUSION:This brief group-based supportive educational intervention for mothers with babies in NCU was feasible, acceptable and helpful in reducing stress related to NCU. Larger controlled trials are recommended to establish the generalizability of these findings in this region.
Are A, Olisah V, Bella-Awusah T, et al., 2021, Controlled clinical trial of teacher-delivered Cognitive Behavioural Therapy (CBT) for adolescents with clinically diagnosed depressive disorder in Nigeria, INTERNATIONAL JOURNAL OF MENTAL HEALTH, Vol: 51, Pages: 4-23, ISSN: 0020-7411
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- Citations: 4
Jibunoh O, Ani C, 2021, A controlled clinical trial of a brief psycho-educational intervention for anxiety among in-school adolescents in Nigeria, INTERNATIONAL JOURNAL OF MENTAL HEALTH, Vol: 51, Pages: 24-31, ISSN: 0020-7411
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- Citations: 2
Ayyash HF, Ogundele MO, Lynn RM, et al., 2021, Involvement of community paediatricians in the care of children and young people with mental health difficulties in the UK: implications for case ascertainment by child and adolescent psychiatric, and paediatric surveillance systems, BMJ Paediatrics Open, Vol: 5, ISSN: 2399-9772
Objective: To ascertain the extent to which community paediatricians are involved in the care of children with mental health conditions in order to determine which difficulties are appropriate for single or joint surveillance by the British Paediatric Surveillance Unit (BPSU) and Child and Adolescent Psychiatry Surveillance System (CAPSS). Design: An online survey of the 1120 members of the British Association of Community Child Health (BACCH) working in 169 Community Child Health (CCH) services in the UK. Results: A total of 245 community paediatricians responded to the survey. This represents 22% of members of BACCH but likely to have covered many of the 169 CCH units because participants could respond on behalf of other members in their unit. The survey showed that children and young people (CYP) with neurodevelopmental conditions presented more frequently to paediatrics than to Child and Adolescent Mental Health Services (CAMHS). In addition, a sizeable proportion of CYP with emotional difficulties presented to paediatricians (eg, 29.5% for anxiety/obsessive compulsive disorder (OCD), and 12.8% for depression)-mainly due to difficulty with accessing CAMHS. More than half of the community paediatricians are involved in the care of CYP with anxiety and OCD, while 32.3% are involved in the care of those with depression. Conclusion: There is significant involvement of community paediatricians in the care of CYP with mental health conditions. Involvement is highest for neurodevelopmental conditions, but also significant for CYP with emotional difficulties. The implication of the findings for surveillance case ascertainment is that joint BPSU and CAPSS is recommended for surveillance studies of neurodevelopmental conditions. However, for emotional disorders, single or joint surveillance should be made based on the specific research question and the relative trade-offs between case ascertainment, and the additional cost and reporting burden of joint surveillance. Singl
Janssens A, Eke H, Price A, et al., 2020, The transition from children’s services to adult services for young people with attention deficit hyperactivity disorder: the CATCh-uS mixed-methods study
<h4>Background</h4>Attention deficit hyperactivity disorder was previously seen as a childhood developmental disorder, so adult mental health services were not set up to support attention deficit hyperactivity disorder patients who became too old for child services. To our knowledge, this is the first in-depth study of the transition of attention deficit hyperactivity disorder patients from child to adult health services in the UK.<h4>Objectives</h4>Our objectives were to explore how many young people with attention deficit hyperactivity disorder are in need of services as an adult, what adult attention deficit hyperactivity disorder services are available and how attention deficit hyperactivity disorder stakeholders experience transition from child to adult services.<h4>Design</h4>An interactive mixed-method design was adopted with three study streams: (1) a 12-month surveillance study with 9-month follow-up to find out how many young people required ongoing medication when they were too old for child services (929 surveys completed by children’s clinicians); (2) a mapping study to identify and describe services for young adults with attention deficit hyperactivity disorder (2686 respondents to online surveys for patients and health workers and freedom of information requests to service providers and commissioners); and (3) a qualitative study to explore key stakeholders’ experiences of transition from child to adult services (144 interviews with 64 attention deficit hyperactivity disorder patients, 28 parents and 52 health clinicians; 38 working in child or adult secondary health services and 14 general practitioners). Members of the public advised at each stage of the study.<h4>Results</h4>When corrected for non-response and case ascertainment, the annual number of young people with an ongoing need for medication for attention deficit hyperactivity disorder lies between 270 and 599 per 100,000 people age
Eke H, Ford T, Newlove-Delgado T, et al., 2020, Transition between child and adult services for young people with attention-deficit hyperactivity disorder (ADHD): findings from a British national surveillance study, BRITISH JOURNAL OF PSYCHIATRY, Vol: 217, Pages: 616-622, ISSN: 0007-1250
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- Citations: 23
Price A, Janssens A, Newlove-Delgado T, et al., 2020, Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups, BJPSYCH OPEN, Vol: 6, ISSN: 2056-4724
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- Citations: 4
Dharampal R, Ani C, 2020, The emotional and mental health needs of young carers: what psychiatry can do, BJPsych Bulletin, Vol: 44, Pages: 112-120, ISSN: 2056-4694
Aims and methodTo review the literature on the emotional and mental health needs of young carers of parents with mental illness and the extent to which such needs are recognised and supported by professionals. Three databases were systematically searched from 2008 to 2018, and five studies met the inclusion criteria.ResultsThe key findings were that young caregivers had a significantly higher dose-response mortality risk than their peers; were at increased risk of mental health difficulties, especially where the ill family member was a parent and had mental illness or misused substances; were overlooked by professionals owing to a lack of awareness; but could derive benefits from their caring role when appropriately supported.Clinical implicationsYoung carers are at increased risk regarding emotional and mental health needs; this risk could be mitigated by professionals recognising the young carer's role and including them in their parent's treatment plan.
Adegbolagun A, Ani C, Adejumo O, et al., 2020, Effect of a group-based cognitive behavioural therapy program on the psychological wellbeing, quality of life and coping of students with sickle cell disease in Nigeria, INTERNATIONAL JOURNAL OF DISABILITY DEVELOPMENT AND EDUCATION, Vol: 69, Pages: 1095-1104, ISSN: 1034-912X
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- Citations: 3
Ibigbami O, Adeniyi Y, Omigbodun O, et al., 2020, The Effect of Training on Functional Behavioural Analysis on Teacher Self-Efficacy Among Special Education Teachers in Osun State, Southwestern Nigeria, INTERNATIONAL JOURNAL OF SPECIAL EDUCATION, Vol: 35, Pages: 73-82, ISSN: 0827-3383
Eke H, Janssens A, Downs J, et al., 2019, How to measure the need for transition to adult services among young people with Attention Deficit Hyperactivity Disorder (ADHD): a comparison of surveillance versus case note review methods, BMC MEDICAL RESEARCH METHODOLOGY, Vol: 19
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- Citations: 5
Tungchama FP, Egbokhare O, Omigbodun O, et al., 2019, Health workers? attitude towards children and adolescents with mental illness in a teaching hospital in north-central Nigeria, JOURNAL OF CHILD AND ADOLESCENT MENTAL HEALTH, Vol: 31, Pages: 125-137, ISSN: 1728-0583
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- Citations: 6
Isa EW, Ani C, Bella-Awusah T, et al., 2018, Effects of psycho-education plus basic cognitive behavioural therapy strategies on medication-treated adolescents with depressive disorder in Nigeria, JOURNAL OF CHILD AND ADOLESCENT MENTAL HEALTH, Vol: 30, Pages: 11-18, ISSN: 1728-0583
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- Citations: 7
Lasisi D, Ani C, Lasebikan V, et al., 2017, Effect of attention-deficit-hyperactivity-disorder training program on the knowledge and attitudes of primary school teachers in Kaduna, North West Nigeria, CHILD AND ADOLESCENT PSYCHIATRY AND MENTAL HEALTH, Vol: 11
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- Citations: 16
Bello-Mojeed M, Ani C, Lagunju I, et al., 2016, Feasibility of parent-mediated behavioural intervention for behavioural problems in children with Autism Spectrum Disorder in Nigeria: a pilot study, Child and Adolescent Psychiatry and Mental Health, Vol: 10, ISSN: 1753-2000
BACKGROUND: Autism Spectrum Disorders (ASD) is a disabling and lifelong neuro-developmental disorder. Challenging behaviours such as aggression and self injury are common maladaptive behaviours in ASD which adversely affect the mental health of both the affected children and their caregivers. Although there is evidence-base for parent-delivered behavioural intervention for children with ASD and challenging behaviours, there is no published research on the feasibility of such an intervention in sub-Saharan Africa. This study assessed the feasibility of parent-mediated behavioural intervention for challenging behaviour in children with ASD in Nigeria. METHODS: This was a pre-post intervention pilot study involving 20 mothers of children with DSM-5 diagnosis of ASD recruited from a Child and Adolescent Mental Health Service out-patient Unit. All the mothers completed five sessions of weekly manualised group-based intervention from March to April, 2015. The intervention included Functional Behavioural Analysis for each child followed by an individualised behaviour management plan. The primary outcome measure was the Aggression and Self Injury Questionnaire, which assessed both Aggression towards a Person and Property (APP) and Self Injurious Behaviour (SIB). The mothers' knowledge of the intervention content was the secondary outcome. All outcome measures were completed at baseline and after the intervention. The mothers' level of satisfaction with the programme was also assessed. Treatment effect was evaluated with Wilcoxon Signed Rank Tests of baseline and post-intervention scores on outcome measures. RESULTS: The children were aged 3-17 years (mean = 10.7 years, SD 4.6 years), while their mothers' ages ranged from 32 to 52 years (mean 42.8 years, SD 6.4 years). The post intervention scores in all four domains of the APP and SIB were significantly reduced compared with pre-intervention scores. The mothers' knowledge of the inter
Abdulmalik J, Ani C, Ajuwon AJ, et al., 2016, Effects of problem-solving interventions on aggressive behaviours among primary school pupils in Ibadan, Nigeria, Child and Adolescent Psychiatry and Mental Health, Vol: 10, ISSN: 1753-2000
BACKGROUND: Aggressive patterns of behavior often start early in childhood, and tend to remain stable into adulthood. The negative consequences include poor academic performance, disciplinary problems and encounters with the juvenile justice system. Early school intervention programs can alter this trajectory for aggressive children. However, there are no studies evaluating the feasibility of such interventions in Africa. This study therefore, assessed the effect of group-based problem-solving interventions on aggressive behaviors among primary school pupils in Ibadan, Nigeria. METHODS: This was an intervention study with treatment and wait-list control groups. Two public primary schools in Ibadan Nigeria were randomly allocated to an intervention group and a waiting list control group. Teachers rated male Primary five pupils in the two schools on aggressive behaviors and the top 20 highest scorers in each school were selected. Pupils in the intervention school received 6 twice-weekly sessions of group-based intervention, which included problem-solving skills, calming techniques and attribution retraining. Outcome measures were; teacher rated aggressive behaviour (TRAB), self-rated aggression scale (SRAS), strengths and difficulties questionnaire (SDQ), attitude towards aggression questionnaire (ATAQ), and social cognition and attribution scale (SCAS). RESULTS: The participants were aged 12 years (SD = 1.2, range 9-14 years). Both groups had similar socio-demographic backgrounds and baseline measures of aggressive behaviors. Controlling for baseline scores, the intervention group had significantly lower scores on TRAB and SRAS 1-week post intervention with large Cohen's effect sizes of 1.2 and 0.9 respectively. The other outcome measures were not significantly different between the groups post-intervention. CONCLUSIONS: Group-based problem solving intervention for aggressive behaviors among primary school students showed significant reductio
Ola B, Suren R, Ani C, 2015, Depressive symptoms among children whose parents have serious mental illness: Association with children's threat-related beliefs about mental illness, South African Journal of Psychiatry, Vol: 21, Pages: 74-78, ISSN: 1608-9685
Background. Sixty-eight per cent of women and 57% of men with mental illness are parents. There is increasing evidence of adversepsychosocial impact of parental mental illness on their children. However, among children whose parents have mental illness, the potentialcontribution of the children’s beliefs about mental illness to their own emotional distress is still poorly understood.Aim. To explore among children whose parents have serious mental illness, the relationship between the children’s beliefs about mentalillness and their own depressive symptoms.Methodology. We conducted an interview-administered questionnaire survey of 67 Nigerian children whose parents were psychiatricinpatients. The children’s beliefs about mental illness were explored with five questions – two of which embedded threat-related beliefs.Their depressive symptoms were assessed with the Short Mood and Feelings Questionnaire (SMFQ) (Cronbach alpha 0.91). Based on stigmatheory, we hypothesised that among this cohort, the children who hold threat-related beliefs about people with mental illness would reportstatistically significantly more depressive symptoms than those without similar beliefs.Results. The mean age (standard deviation (SD)) of the children was 13.3 (2.8) years, and 38% were males. Twenty-four per cent of thechildren believed mental illness is infectious. In line with our hypothesis, those holding this belief had statistically significantly moredepressive symptoms compared with those without similar beliefs (p=0.001). Fifty-seven per cent of the children believed that peoplewith mental illness are dangerous. However, contrary to our hypothesis, this belief was not associated with increased depressive symptoms(p=0.2). Multiple regression showed that statistically significant predictors of increased emotional symptoms were ‘belief that mental illnessis infectious’ and younger age. The model explained 39.8% of the variance in SMFQ.Conclusion. In
Bella-Awusah T, Ani C, Ajuwon A, et al., 2015, Effectiveness of brief school-based, group cognitive behavioural therapy for depressed adolescents in south west Nigeria, Child and Adolescent Mental Health, Vol: 21, Pages: 44-50, ISSN: 1475-3588
BackgroundThere is paucity of evidence-based psychological interventions for depressive disorders in Africa, more so among depressed children and adolescents. This study aimed to determine the effects of a school-based cognitive behavioural therapy programme (CBT) on depressed adolescents in South West Nigeria.MethodsForty students who scored 18 or above on the Beck Depression Inventory (BDI) were recruited from two schools (20 from each school). One school was designated intervention and the other a wait-list control school. Five weekly sessions of group CBT programme were conducted in the intervention school. Primary outcome measure was the Beck Depression Inventory, and secondary outcome measures were the Short Mood and Feelings Questionnaire and the Impact Supplement of the Strengths and Difficulties Questionnaire.ResultsControlling for baseline scores and other confounders, the intervention group had significantly lower depressive symptoms scores on the BDI and SMFQ 1 week post intervention with large effect sizes. The intervention group maintained the treatment effect with significantly lower depression scores 16 weeks post intervention compared with their baseline scores. The effect sizes remained large. The intervention and control groups did not differ in their SDQ impact supplement scores post intervention, but the intervention group improved significantly on this measure at 16 weeks.ConclusionsTo our knowledge, this is the first study of a school-based group CBT programme for depressed adolescents in Africa. The programme showed good feasibility and promising effectiveness.
Imran N, Ani C, Mahmood Z, et al., 2013, Anxiety and depression predicted by medically unexplained symptoms in Pakistani Children: A case-control study., . Journal of Psychosomatic Research
Ola B, Coker R, Ani C, 2013, Stigmatising attitudes towards peers with sickle cell disease among secondary school students in Nigeria., International Journal of Child Youth and Family Studies
Ani C, Reading R, Lynn R, et al., 2013, Incidence and 12-month outcome of non-transient childhood conversion disorder in the UK and Ireland, BRITISH JOURNAL OF PSYCHIATRY, Vol: 202, Pages: 413-418, ISSN: 0007-1250
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- Citations: 72
Taylor S, Ani C, 2012, Emotions and Behaviour, Illustrated Textbook of Paediatrics, ISBN: 9780723438748
Ellis JM, Tan HK, Gilbert RE, et al., 2008, Supplementation with antioxidants and folinic acid for children with Down's syndrome: randomised controlled trial, BMJ-BRITISH MEDICAL JOURNAL, Vol: 336, Pages: 594-597, ISSN: 1756-1833
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- Citations: 62
Ani C, Ani O, 2007, Institutional racism - Editorial is unduly provocative, BRITISH MEDICAL JOURNAL, Vol: 334, Pages: 761-761, ISSN: 0959-8146
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