CONTEXT: Most medical doctors are likely to work with patients experiencing mental health conditions. However, there are often limited educational opportunities for medical doctors to achieve professional development in the field of psychiatry. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES:To assess the effectiveness of simulation training in psychiatry for medical students, post-graduate trainees, and medical doctors. METHODS:For this systematic review and meta-analysis, we searched 8 electronic databases and trial registries up to August 31, 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group prepost-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from Randomised Controlled Trials (RCTs) using random-effects models. RESULTS:From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n=69), simulated patients (n=72), virtual reality (n=22), manikin (n=5) and voice simulation (n=2). Meta-analysis found significant differences at immediate post-test for simulation compared with active and inactive controls on attitudes (SMD=0.52 (95%CI 0.31; 0.73; I 2 = 0%) and 0.28 (95%CI 0.04; 0.53; I 2 = 52%), respectively); on skills (SMD=1.37 (95%CI 0.56; 2.18; I 2 =93%) and 1.49 (95%CI 0.39; 2.58; I 2 = 93%), respectively); on knowledge (SMD=1.22 (95%CI 0.57; 1.88; I 2 = 0%) and 0.72 (95%CI 0.14; 1.30; I 2 = 80%), respectively); and on behaviours (SMD= 1.07 (95%CI 0.49; 1.65; I 2 =68%) and 0.45 (95%CI 0.11; 0.79; I 2 =41%), respectively. Significant differences were found at three-month follow-up for patient benefit and doctors' behaviours and skills. CONCLUSIONS: Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.

Concerns have been raised about early vs. later impacts of the COVID-19 pandemic on suicidal behavior. However, data remain sparse to date. We investigated all calls for intentional drug or other toxic ingestions to the eight Poison Control Centers in France between 1st January 2018 and 31st May 2022. Data were extracted from the French National Database of Poisonings. Calls during the study period were analyzed using time trends and time series analyses with SARIMA models (based on the first two years). Breakpoints were determined using Chow test. These analyses were performed together with examination of age groups (≤ 11, 12–24, 25–64, ≥ 65 years) and gender effects when possible. Over the studied period, 66,589 calls for suicide attempts were received. Overall, there was a downward trend from 2018, which slowed down in October 2019 and was followed by an increase from November 2020. Number of calls observed during the COVID period were above what was expected. However, important differences were found according to age and gender. The increase in calls from mid-2020 was particularly observed in young females, while middle-aged adults showed a persisting decrease. An increase in older-aged people was observed from mid-2019 and persisted during the pandemic. The pandemic may therefore have exacerbated a pre-existing fragile situation in adolescents and old-aged people. This study emphasizes the rapidly evolving situation regarding suicidal behaviour during the pandemic, the possibility of age and gender differences in impact, and the value of having access to real-time information to monitor suicidal acts.

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IntroductionAlthough most healthcare professionals must deal with patients with mental illness, many are not prepared for the various situations that can ensue. Simulation may be a powerful pedagogical tool for simultaneously teaching knowledge, skills and attitudes. We aim to assess the effectiveness of simulation for initial and continuous training in psychiatry for healthcare professionals.Methods and analysisA comprehensive search for randomised and non-randomised controlled studies and single-group pretest/post-test reports will be conducted in electronic databases including MEDLINE, EMBASE, Scopus, CINAHL, PsychINFO, ERIC, the Cochrane Central Register of Controlled Trials (CENTRAL) and the Web of Science (Science and Social Sciences Citation Index), with a detailed query. The reference lists of selected studies, key journals and trial registers will also be searched for additional studies. Two independent reviewers, following predefined inclusion criteria, will screen titles and abstracts first and then the full texts of the remaining articles. A third author will evaluate discrepancies to reach a consensus. It will include randomised controlled trial (RCT), non-RCT, pre-test/post-test design studies, post-test design for satisfaction evaluation and qualitative studies. Risk of bias will be assessed by using the Cochrane Collaboration Tool for assessing risk of bias in RCTs. Meta-analyses will be performed if we find sufficient studies that assess predefined outcomes and if their characteristics are not too different. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluation. A narrative synthesis will be performed for qualitative studies and when meta-analyses are deemed not possible.Ethics and disseminationEthics permission is not required. Dissemination will be through publication in peer-reviewed journals, national and international conferences, and the lead author’s doctoral dissertation.Trial registration numberCRD42017078779.

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Aims Mental disorders constitute one of the main causes of disease and disability worldwide. While nurses are often at the frontline of mental health care, they have limited access to dedicated psychiatric training opportunities. Simulation training may foster the development of the appropriate competencies required when supporting people with mental disorders. To evaluate the effectiveness of simulation training in psychiatry for nursing students, nurses and nurse practitioners. Design Systematic review and meta‐analysis. Data sources Eight electronic databases, trial registries, key journals and reference lists of selected studies were searched from inception to August 20, 2020 without language restriction. Review Methods We included randomized and non‐randomized controlled studies and single group pre/post studies. Cochrane Risk of Bias tool 2.0 was used for randomized controlled study appraisal, and the Medical Education Research Study Quality instrument was completed for all other studies. Meta‐analysis was restricted to randomized controlled studies. The other studies were synthesized narratively. The main outcomes were based on Kirkpatrick levels. Results A total of 118 studies (6738 participants) were found. Interventions included simulated patients (n = 55), role‐plays (n = 40), virtual reality (n = 12), manikins (n = 9) and voice simulations (n = 9). Meta‐analyses based on 11 randomized controlled studies found a significant large effect size on skills at immediate post‐test for simulation compared with active control; and a small and medium effect size on learners’ attitudes for simulation compared with inactive control, at immediate post‐test and at three‐month follow‐up respectively. Three quarters of non‐randomized controlled studies and pre/post‐tests assessing attitudes and skills showed significant differences, and three quarters of participants in randomized controlled studies and pre/post‐tests showed significant differences in behaviours. Among the few studies assessing people with mental health outcomes, almost all reported significant differences. Conclusion These findings support the effectiveness of simulation training in psychiatric nursing throughout professional development grades, despite heterogeneity in methods and simulation interventions.

BackgroundQigong is a mind-body intervention focusing on interoceptive awareness that appears to be a promising approach in anorexia nervosa (AN). In 2008, as part of our multidimensional treatment program for adolescent inpatients with AN, we began a weekly qigong workshop that turned out to be popular among our adolescent patients. Moreover psychiatrists perceived clinical benefits that deserved further exploration.Methods and findingsA qualitative study therefore sought to obtain a deeper understanding of how young patients with severe AN experience qigong and to determine the incentives and barriers to adherence to qigong, to understanding its meaning, and to applying it in other contexts. Data were collected through 16 individual semi-structured face-to-face interviews and analyzed with the interpretative phenomenological analysis method. Eleven themes emerged from the analysis, categorized in 3 superordinate themes describing the incentives and barriers related to the patients themselves (individual dimension), to others (relational dimension), and to the setting (organizational dimension). Individual dimensions associated with AN (such as excessive exercise and mind-body cleavage) may curb adherence, whereas relational and organizational dimensions appear to provide incentives to join the activity in the first place but may also limit its post-discharge continuation. Once barriers are overcome, patients reported positive effects: satisfaction associated with relaxation and with the experience of mind-body integration.ConclusionsQigong appears to be an interesting therapeutic tool that may potentiate psychotherapy and contribute to the recovery process of patients with AN. Further analysis of the best time window for initiating qigong and of its place in overall management might help to overcome some of the barriers, limit the risks, and maximize its benefits.

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