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Epidemiol Psychiatr Sci. 2014 Jun;23(2):167-76. doi: 10.1017/S2045796013000334. Epub 2013 Jul 18.

Effectiveness of brief suicide management training programme for medical residents in Japan: a cluster randomized controlled trial.

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Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.
Psycho-oncology Division, National Cancer Center East, and Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Department of Epidemiology and Biostatistics, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Disaster Psychiatry and Community Psychiatry, Iwate Medical University, Iwate, Japan.


Aims. To evaluate the effectiveness of a brief suicide management training programme for Japanese medical residents compared with the usual lecture on suicidality. Methods. In this multi-center, clustered randomized controlled trial, the intervention group attended a structured suicide management programme and the control group, the usual lecture on depression and suicidality. The primary outcome was the difference in residents' cumulative competency score to manage suicidal persons from baseline (T0) to 1 month after the intervention (T2), determined using the Suicide Intervention Response Inventory (SIRI-1) score, at individual level. Results. Analysis of 114 residents (intervention group n = 65, control group n = 49) assigned to two clusters in each group revealed no change in SIRI-1 score from T0 to T2 or immediately after the intervention (T1) between the two groups. As a secondary analysis, discrepancy in judgement between the participants and Japanese suicidologists was examined immediately after the intervention in the adjusted model, with a mean difference in score of 9.98 (95% confidence interval: 4.39-15.56; p = 0.001). Conclusions. The structured programme was not proven to improve competency in suicide management when measured by the SIRI-1 score. Further elaboration of the programme and valid measurement of its outcome would be needed to show the program's effectiveness.

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