Crisis-management, Anti-stigma, and Mental Health Literacy Program for University Students (CAMPUS): A preliminary evaluation of suicide prevention [version 2; peer review: 2 approved]

Background: University students have specific risk factors for suicide, necessitating targeted prevention programs. This preliminary study evaluated the efficacy of the Crisis-management, Anti-stigma, Mental health literacy Program for University Students (CAMPUS) for reduction of risk factors and promotion of preventative behaviors. Methods: A total of 136 medical students attended the CAMPUS as a required course at the national university in Japan. The CAMPUS consisted of a lecture and two group sessions covering mental health literacy, self-stigma, and gatekeeper efficacy (e.g., identifying and helping at-risk individuals). The students were asked to role-play based on a movie about gatekeepers and scripts about self-stigma and suicide-related issues. Participants completed questionnaires on suicidal thoughts, depression, help-seeking intentions, self-efficacy as gatekeepers, self-concealment, and self-acceptance. A total of 121 students completed the questionnaires pre- and post-program, and 107 students also responded six months later. Results: Students demonstrated significantly reduced overall suicide thoughts six months post-program compared to before the program. In addition, gatekeeper self-efficacy, help-seeking intentions for formal resources, and self-acceptance were improved in the students six month after the program. Conclusions: The CAMPUS suggested effective at reducing suicidal people and promoting preventative psychological tendencies among medial students. This study was a one-group pre post design study without control group. The CAMPUS program was delivered as a mandatory requirement to a group with relatively low suicide risk. Further studies are required to assess its suitability for the general university student population

Verifying the Japanese version of the Preschool Confusion Assessment Method for the ICU (psCAM‐ICU)

AimPediatric delirium has been well investigated and its prevalence is reported to be from 20% to 44%. For pediatric intensive care settings, several validated assessment tools for diagnosing delirium, including the Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM‐ICU), are available in English. However, validated assessment tools for identifying pediatric delirium are unavailable in Japanese. Therefore, the aim of this study is to verify the Japanese translation of the psCAM‐ICU.MethodsWe enrolled patients at the Pediatric ICU at University of Tsukuba Hospital (Tsukuba, Japan) from May 2017 to February 2019. Enrollment criteria included patients aged 6 months to 5 years, and we excluded coma patients scoring under −4 on the Richmond Agitation–Sedation Scale or suffering from stroke. Pediatric patient delirium was simultaneously evaluated by three medical workers (pediatric intensivist and researchers). Psychiatrists then verified these findings against criteria of the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition. We evaluated criterion validity (sensitivity and specificity) and reliability using Cohen\u27s κ coefficient.ResultsWe made a total of 56 independent assessments of 19 patients (42% female) with an average age of 18 (±15) weeks. Mechanical ventilation was used at least once in 73% of patients and the positive rate of delirium was 54% in total observation. Overall, the psCAM‐ICU showed high sensitivity, specificity (sensitivity, 0.90 [95% confidence interval [CI], 0.80–0.94]; specificity, 0.93 [95% CI, 0.83–0.97]), and high reliability within the researcher assessments (κ = 0.92; 95% CI, 0.82–1.0).ConclusionWe verified the psCAM‐ICU and it shows high validity and reliability

Apathy symptoms induced by low‐dose venlafaxine: Two cases

Abstract Recent guidelines regarding pharmacological interventions for major depressive disorder (MDD) recommend first using serotonin (5HT) selective reuptake inhibitors (SSRIs) or 5HT and norepinephrine (NE) reuptake inhibitors (SNRIs). Although SSRIs and SNRIs are effective and well‐tolerated, apathy occurs as an adverse effect in some SSRIs‐treated patients. Because apathy would be associated with the 5HT pathway, if a patient exhibits apathy symptoms under SSRIs treatment, a clinical strategy has been to change the SSRIs to treatment with an SNRIs. Here, I report two cases in which low‐dose venlafaxine, an SNRIs, induced apathy symptoms

Crisis-management, Anti-stigma, and Mental Health Literacy Program for University Students (CAMPUS): Evaluating longitudinal efficacy for reducing suicide risk

Background: University students have specific risk factors for suicide, necessitating targeted prevention programs. This longitudinal study evaluated the efficacy of the Crisis-management, Anti-stigma, Mental health literacy Program for University Students (CAMPUS) for reduction of risk factors and promotion of preventative behaviors. Methods: A total of 136 medical students attended the CAMPUS as a required course at the University of Tsukuba. The CAMPUS consisted of a lecture and two group sessions covering mental health literacy, self-stigma, and gatekeeper efficacy (e.g., identifying and helping at-risk individuals). The students were asked to role-play based on a movie about gatekeepers and scripts about self stigma and suicide-related issues. Participants completed questionnaires on suicidal behavior, depression, help-seeking intentions, self-efficacy as gatekeepers, self-concealment, and self-acceptance. Results: A total of 121 students completed the questionnaires pre- and post-program, and 107 students also responded 6 months later. Higher-risk students demonstrated significantly reduced suicide risk 6 months post-program compared to before the program. In addition, gatekeeper self-efficacy, help-seeking intentions for formal resources, and self-acceptance were improved in both low and higher-risk students 6 month after the program. Limitations: The CAMPUS program was delivered as a mandatory requirement to a group with high scholastic abilities and relatively low suicide risk. Further studies are required to assess its suitability for the general university student population. Conclusions: The CAMPUS proved effective at reducing risk factors for suicide and promoting preventative behaviors among university students

Comparing educational effects between role-play and gatekeeper training in Crisis-management, Anti-stigma, and Mental Health Literacy Program for University Students (CAMPUS)

Aims: We compare the educational effects of role-play and discussion and gatekeeper training to develop an evidence-based suicide prevention education program for university students. Methods: Participants comprised 145 medical students. “Crisis-management, Anti-stigma and Mental Health Literacy Program for University Students” (CAMPUS) was designed and developed, which included a lecture and a parallel session for role-play or gatekeeper training. Students attended a lecture and were randomly assigned to the role-play group or gatekeeper training group. Questionnaires were filled before the module, immediately after the module, and three months after the program. Results: The role-play group learned more appropriate coping skills, whereas the gatekeeper training group improved their self-efficacy as gatekeepers. The students’ depressive state had decreased at three months after the program, along with the reduced suicide probability in students with suicide risk. Conclusions: Role-play and gatekeeper training evinced different educational effects. However, CAMPUS was comprehensively effective in preventing suicide in university students