Suicide is one of the most critical issues worldwide. In Japan, more than 30 000 people died by suicide every year between 1998 and 2011, and the Japanese government, local governments, and various other agencies have been working on suicide prevention programs to reduce the suicide rate. While the number of suicides is still high (more than 20 000 per year), many specialists are striving to further reduce the number of suicides in Japan. The Japanese government has played a central role in suicide prevention through the enactment of several laws, and in recent years, suicide prevention has shifted from government to community-specific measures. This review discusses the suicide prevention measures that have been taken so far: (1) policy strategies for suicide prevention by the Japanese government, (2) community suicide prevention, and (3) strategic studies for suicide prevention. Finally, as shown in the ACTION-J study, we conclude that cooperation among related organizations in the community, not just one institution, is important for future suicide prevention, especially youth suicide prevention.
To investigate macroprolactinemia caused by antipsychotics and its clinical significance.
A total of 133 patients with schizophrenia were selected, all of whom were treated with either risperidone or amisulpride alone. The levels of total prolactin (T-PRL) and macroprolactin (MPRL) were measured before treatment as well as the second, fourth, and sixth weeks of treatment.
After 2 weeks of treatment, 75.09% (100/133) of the patients met the diagnostic criteria for hyperprolactinemia, the incidence of macroprolactinemia was 43% (43/100), and MPRL levels were positively correlated T-PRL levels.
Risperidone and amisulpride caused hyperprolactinemia and macroprolactinemia; thus, detection of MPRL in the clinical setting should be performed as this phenomenon appears early in treatment (the second week) and continues, that can avoid unnecessary examination and treatment for asymptomatic patients with macroprolactinemia.
This comprehensive meta-analysis aimed to combine data from different studies and to estimate the association between FKBP5 polymorphisms and depression.
We performed a meta-analysis of observational studies. An electronic search was conducted on four databases for articles published before July 1, 2020.
A total of 5125 patients with depression and 8399 controls from 16 independent studies were included in the analysis. The results showed that FKBP5 rs1360780 was associated with the risk of depression in the codominant model (CT vs. CC; OR = 1.10, 95% CI = 1.00–1.20, P = .04); rs4713916 polymorphism was associated with depression in the codominant model (AG vs. GG; OR = 1.19, 95% CI = 1.05–1.34, P = .008) and recessive model (AA vs. AG + GG; OR = 0.74, 95% CI = 0.56–0.99, P = .04); a significant association between rs3800373 and depression was found in the codominant genetic model (AC vs. AA; OR = 1.18, 95% CI = 1.05–1.34, P = .007) and dominant model (CC + AC vs. AA; OR = 1.15, 95% CI = 1.03–1.30, P = .02); there was no significant association of FKBP5 rs9470080 or rs9296158 with depression in any genetic model (P > .05). No publication bias was observed in our analysis. Moreover, sensitivity analyses demonstrated the Zobel's study significantly affected the heterogeneity for rs4713916 and rs3800373.
FKBP5 rs1360780 was associated with an increased risk of depression in the codominant model. We also found that rs4713916 and rs3800373 were involved in depression, rs4713916 was positively associated with depression in the codominant model and recessive model, and rs3800373 was related to an elevated risk of depression in the codominant model and dominant model.
The caregivers of people with schizophrenia might suffer from various problems. We investigated the prevalence of depression, anxiety, and stress among them, and factors associated with their quality of life. A cross-sectional study in communities of rural areas was conducted. We found that the prevalence of depression, anxiety, and stress were 14.2%, 25.5%, and 6.6%, respectively. Their quality of life was independently associated with family functioning (affective responsiveness, problem solving, communication) and the presence of depressive symptoms (p < .05). Schizophrenia caregivers need more supports from health care professionals to improve their skills in problem solving.
The study aimed to compare thyroid function between psychosis with postpartum onset (PPO), psychosis without postpartum onset (PWPO), and normal postpartum females (HC). Twenty women were recruited in each of the three groups. The PPO group had significantly greater psychopathology and shorter episodes compared to the PWPO group. The PPO group was found to have significantly greater right lobe volume than the other groups. The PPO group also had significantly higher FT4 levels than the HC group. We conclude that isolated increase in FT4 and thyroid lobe volumetric changes could be more specifically associated with psychosis of post-partum onset.
Suicide involves a complex set of behaviors and emotions that lead up to actions that may be based on planning and forethought or the result of impulse. While there are a host of antecedent circumstances the presence of a mood disorder, primarily depression, is the most common factor in suicide. While management of depression is recognized as important prevention strategy in depression, the means by which suicide occurs must be a critical element of prevention. Policies that lower access to the means for suicide will decrease the fatality. Guns are associated with half of suicides and the case fatality rate of gun associated suicide is over 90% compared to 7% for all other means. This emphasizes the importance of offering strategies that limit access to guns to those at higher risk for suicide. A declaration of formal self-exclusion for access to firearms (guns and ammunition) offers the individual at greater risk for suicide to place themselves on an official list that would prevent them from purchasing lethal weapons. A person with depression, when well, might wish to enroll voluntarily to prevent themselves, when ill, from procuring a weapon to harm themselves or others. This recognizes the autonomy of the person and protects both the individual, the family, and society.
Dialectical behavior therapy (DBT) is the most commonly used treatment for patients suffering from borderline personality disorder (BPD). However, data on its applications in Asian countries remain lacking. This pilot study aims to evaluate the feasibility and effectiveness of applying Mandarin-translated DBT among suicidal Chinese patients with BPD in Taiwan.
An open-label trial design was implemented for the 1-year standard DBT model. Patients from a psychiatric outpatient department in a general hospital in Taiwan with a history of ≥2 episodes of suicidal behavior within the previous year and who scored >40 on the Borderline Symptom List were invited to participate in this trial. Outcomes of suicidal behaviors, severity of BPD and depression symptoms, suicidal ideation, hopelessness, and quality of life were assessed at the beginning of the treatment and every 3 months until 12 months.
Eighteen patients participated, three of whom (16.7%) dropped out. Significant improvements were found in the frequency and severity of suicidal behaviors and ideations, depressive symptoms, and BPD symptoms beginning as early as the third month after initiating DBT.
This pilot study found that DBT may be an effective and feasible intervention for Mandarin-speaking individuals with a recent history of suicidal behaviors with BPD. Future randomized controlled trials with comparison groups are needed to further determine the efficacy of DBT on this population.
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