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Objectives: Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of potentially suicidal patients and assessed the correlation with the residents' background characteristics. Method: The authors conducted a multicenter, cross-sectional survey of 114 medical residents in Japan, using a modified version of the Suicide Intervention Response Inventory (SIRI-2), the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8), and a 5-point Likert scale to assess confidence in suicide management. Results: A majority (89.5%) of the residents rated their confidence in managing suicidal patients as Not At All Confident or Rather Not Confident, although most were close to completing their psychiatric rotation. Results on the SIRI-2 suggested intermediate competence in managing suicidal behavior, as compared with that of other healthcare professionals. Competence as indicated by the SIRI-2 score was weakly and negatively correlated with the score for self-perceived Vitality on the SF-8 scale. Conclusion: Insufficient skills and lack of confidence in the management of suicidal patients was observed in this sample of Japanese medical residents, thus highlighting the need for improved suicide-management programs for junior medical residents in Japanese hospitals.

Aim Numerous reports have described differences in the distribution of orbitofrontal cortex ( OFC) sulcogyral patterns between patients with schizophrenia ( SZ patients) and healthy controls ( HC). Alterations in OFC morphology are also observed in those at high risk for developing SZ and in first-episode SZ, suggesting that genetic associations may be extant in determining OFC sulcogyral patterns. We investigated the association between single nucleotide polymorphisms ( SNP) in NRG1 and OFC sulcogyral patterns. Methods A total of 59 Japanese patients diagnosed with SZ and 60 HC were scanned on a 1.5-T magnet. Patients were also assessed clinically. OFC sulcogyral patterns were evaluated for each participant, and genotyping was performed for four SNP in NRG1 ( SNP8NRG243177, SNP8NRG221533, SNP8NRG241930, and rs1081062 ). Results There were significant differences in the distribution of OFC sulcogyral patterns between SZ patients and HC (χ2 = 6.52, P = 0.038). SZ patients showed an increase in the frequency of Type III expression, which was associated with an earlier age of disease onset (β = −0.302, F = 4.948, P = 0.030). Although no difference was found in genotype frequencies between SZ patients and HC, an NRG1 SNP, SNP8NRG243177, was associated with Type II expression in SZ patients (β = 0.237, F = 4.120, P = 0.047). Conclusion Our results suggest that OFC sulcogyral pattern formation in schizophrenia may be associated with NRG1 allele frequency, which is closely related to neurodevelopment. [ABSTRACT FROM AUTHOR]

The Mental Health First Aid (MHFA) program is a training program for non-health professionals that deals with persons with a mental health crisis (Kitchener & Jorm, 2006). The MHFA-Japan team was established in 2007, and a founding member completed a MHFA training program in Melbourne, University of Australia. We consulted with Jorm and Kitchener, and started a Japanese study of the program. Providing the MHFA program for gatekeepers in Japan could help them assess risk factors and refer patients for professional care, and contribute to suicide prevention. Our team cooperated with the gatekeeper training program of the cabinet office of the Japanese government. In addition, this program is applied in instructional activities in the area of the Great East Japan Earthquake.

Local caregivers such as psychiatric service providers, mental health welfare workers, and nursing-care staff have a major role to play in the long-term support of survivors of the Great Eastern Japan Earthquake of March 11th, 2011. Alcohol-related problems often cause various problems mentally, physically, economically, and socially. Alcoholics tend to show violent behavior, deny their own alcoholism, cause codependency in significant others, and occasionally relapse. Local caregivers bear the burden of caring for them and feel responsible for their relapse. This leads to exhaustion and discomfort with caring for them. In order to provide continuous and effective support for people with alcohol-related problems, it is important for caregivers to know the nature of the illness, the means and stages of recovery, effective support strategies, and how to enjoy providing support. A Leadership Training course on "Mental Health First Aid (MHFA)" was held in November 2011 for caregivers in Iwate Prefecture. MHFA provides help for people suffering from a mental health problem or in a mental health crisis, developed in Australia by Betty A. Kitchener and Anthony F. Jorm. In 2006, the MHFA-Japan (MHFA-J) Project Team translated the program and modified it to fit Japanese culture. The action plan consists of 5 part: 1) Approach the person, assess and assist with any crises, 2) Listen non-judgmentally, 3) Give support and information, 4) Encourage the person to get appropriate, professional help, 5) Encourage other support/self-help. During the leadership training course, MHFA for anxiety disorder, depression, suicidal thoughts, and alcohol-related problems was introduced, as well as how to train caregivers in experience-based and participatory approaches. The session for alcohol-related problems focused on the process of recovery, including how to deal with relapse, how to listen, how to motivate patients, and how to enjoy being a caregiver. There was also a role-play with two different scenarios: one with a confrontational interview and one with an MHFA-styled interview using a motivational approach. In February 2012, two other seminars focused on alcohol-related problems among the elderly and how to organize a case conference to incorporate requests from participants of the leadership training course. In order to provide long-term support to local caregivers, it is important to convey strategies that focus on caring for others comfortably.