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

「死にたい」と検索する者の相談を促進するインターネット広告の要素は何か？

本研究では自殺関連語を検索する者の援助要請行動を促しやすいインターネット広告の内容を検討した。広告は基本的内容に加えて、見出しに直接的メッセージ（相談してください）か共感的メッセージ（つらかったですね）のどちらかを含め、説明文に相談手段と支援者情報を組み合わせて8種類を作成した。6種類の自殺関連語を検索した結果として広告一つがランダムに表示されるようにGoogle広告を設定した。広告のリンク先ページからボタンをクリックすると電話相談窓口へ発信することができた。ボタンクリックの有無を従属変数、広告の要素を独立変数としたロジスティック回帰分析を行った結果、見出しは共感的メッセージよりも直接的メッセージの方が約1.6 倍、見出しが共感的メッセージの場合には相談手段を説明に含んだ方が約1.2 倍、ボタンクリックの割合が高くなった。すなわち、自殺の相談を促す広告には直接的メッセージと相談手段を含むことが望ましい

Association Between Tooth Loss and Longitudinal Changes in B-Type Natriuretic Peptide Over 5 Years in Postmenopausal Women: The Nagahama Study

BACKGROUND: There is disparity between the sexes in cardiovascular diseases including heart failure (HF). This study aimed to investigate the effect of periodontal disease (PD) on plasma B-type natriuretic peptide (BNP) concentration across sex, age, and menopausal status, as well as the interaction effect of MT and diabetes mellitus (DM) on BNP. METHODS: This large-scale prospective cohort study enrolled 7, 539 individuals with no myocardial infarctions or angina pectoris at baseline from the general Japanese population. The association between baseline number of missing teeth (MT) and the longitudinal changes in BNP over 5 years (ΔBNP) was evaluated according to sex and menopausal status. RESULTS: Among 7, 539 participants, 3, 190 were postmenopausal women with a mean age ± standard deviation of 61.1 ± 7.6 at baseline. Multivariate analysis revealed a positive association between MT and ΔBNP among postmenopausal women even after adjusting for covariates, including traditional HF risk factors (coefficient, 0.210; 95% confidence interval [CI], 0.107 to 0.312; P 50. Including an interaction term (MT × DM) in the multivariate model revealed a positive interaction between MT and DM in ΔBNP among postmenopausal women (coefficient for interaction, 1.365; 95% CI, 0.902 to 1.827; P for interaction <0.001). CONCLUSIONS: Our study showed a positive association between MT and ΔBNP, as well as a positive effect of the interactive association between MT and DM, among postmenopausal women. Our results suggest a sex difference of an adverse effect of PD on initial myocardial wall stress in the ventricles

The effects of the online gatekeeping using search-based advertising on users’ suicidal ideation

Background: Recently, the practice of “online gatekeeping” related to suicide prevention—placing online advertisements directed at users who search the web for suicide-related terms and leading them to email-based consultations—has been implemented. However, the effectiveness of this practice has not been examined. Aim: To quantitatively examine the effectiveness of suicide-related online gatekeeping. Methods: This was a non-randomized, single-arm study of online gatekeeping among Japanese Internet users. Outcomes were measured at the beginning of the use of the consultation service (T1) and approximately four weeks later (T2). The primary outcome measured was suicidal ideation. Results: In total, 167 participants completed two assessment surveys; approximately 80% were women, and 59.3% were young people (in their twenties or younger). Data analysis of 167 online gatekeeping service users showed that the mean suicidal ideation at T2 was statistically significantly lower than that at T1, and its effect size was small to medium (d = 0.38). Limitations: This study used a single-arm design with no control group. Additionally, the study did not include a second follow-up period. Conclusions: Online gatekeeping is a promising suicide-prevention tool, although further research is warranted to examine its effectiveness using a randomized controlled trial

Characteristics of the content of consultation texts of individuals with high levels of suicidal ideation: Text mining of email text in Internet gatekeeper activities

The aim of this study was to identify the characteristics present in the consultation text of individuals at high risk of suicide in a text-based crisis intervention project for suicide prevention. We analyzed data, including online questionnaire responses and consultation text content, from 519 individuals (69.7% of whom were women and 62.8% of whom were under 20) consulted in the Internet Gatekeeper project. Results from correspondence analysis and a comparison of co-occurrence network diagrams indicated that the consultation text of individuals at high risk of suicide often includes references to suicide, death, and suicide methods, references to being a burden to others such as family members and parents, and references to self-hatred. However, there were relatively few references to communication with those around them. By focusing on these key points, it may be possible to more effectively monitor the extent to which the target population of the consultation service includes individuals at high risk of suicide

Demographics Associated With Stress, Severe Mental Distress, and Anxiety Symptoms During the COVID-19 Pandemic in Japan: Nationwide Cross-sectional Web-Based Survey

BackgroundWith the spread of COVID-19, the deterioration of public mental health has become a major global and social problem. ObjectiveThe purpose of this study was to elucidate the relationship between the 3 mental health problems associated with COVID-19, that is, perceived stress, severe mental distress, and anxiety symptoms, and the various demographic factors, including occupation. MethodsA nationwide web-based questionnaire survey was conducted in Japan from August 4 to 31, 2020. In addition to sociodemographic data, the degrees of perceived stress, severe mental distress, and anxiety symptoms associated with COVID-19 were measured. After performing a descriptive statistical analysis, factors related to stress, severe mental distress, and anxiety symptoms were analyzed using logistic regression analysis. ResultsA total of 8203 respondents submitted survey responses, among whom 34.9% (2861/8203) felt intense stress associated with COVID-19, 17.1% (1403/8203) were depressed, and 13.5% (1110/8203) had severe anxiety symptoms. The logistic regression analysis showed that each of the 3 mental health problems were prevalent in females, nonbinary gender, people in their 50s, 60s and older, respondents who visited psychiatrists, and those currently in psychiatric care. Severe mental distress and anxiety symptoms were associated with the number of effective lifestyle coping strategies during the lockdown period. Severe mental distress was only prevalent in teenagers and respondents in their 20s, as students tended to develop stress and severe mental distress. With regard to occupation, working in nursing care and welfare, education and research, and medical and health sectors was associated with stress; however, working in these occupations was not associated with severe mental distress and anxiety symptoms. Unemployment was associated with severe mental distress and anxiety symptoms. All 3 mental health problems were prevalent in part-time workers and those working in entertainment and arts sectors. ConclusionsGender, age, occupation, history of psychiatric visits, and stress coping mechanisms were associated with mental health during the COVID-19 pandemic, but their associations with stress, severe mental distress, and anxiety symptoms differed. In addition, the actual state of mental health varied according to the respondents’ occupation. It is necessary to consider the impact of the COVID-19 pandemic on mental health not only at the individual level but also at the occupational level

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