Characteristics and factors contributing to suicide trends in Japan during the Coronavirus Disaster was reviewed. The spread of the novel coronavirus beginning in 2020 led to the first increase in annual suicides in 11 years. The increase was attributed to both mental health and socioeconomic factors, and to the combined effects of issues at the individual (infection, pre-existing conditions), group (youth, women, restaurant industry, etc.), and societal (media coverage, limited suicide prevention activities) levels. Therefore, the revised Comprehensive National Suicide Prevention Guidelines in 2022 will focus on individual mental health measures, including the use of ICT for counseling, training of mental health and welfare service personnel, improvement of psychiatric care, and enhancement of measures for persons who have attempted suicide. There are high expectations for general hospital psychiatry departments in terms of additional medical care for those who attempt suicide. To prevent after-coronas from further increasing the number of suicides, general hospital psychiatry departments need to improve their support for suicide attempters.

In April 2021, the Physical Emergency Coordination Committee of the Japanese Society of General Hospital Psychiatry initiated the “Multicenter Survey on Abuse and Dependence in Patients Transported to Emergency Departments for Overdose of Over-the-Counter (OTC) Drugs.” The aim of the survey was to explore the actual conditions of abuse/dependence and psychosocial characteristics of patients transported to an emergency department for overdose of OTC drugs. We report the result of the survey in 25 patients (9 males and 16 females, mean age 23.3 ± 10.3 years, median 21.0 years) who were transported to Saitama Medical University Hospital. There were 84% of young participants in their teens or twenties. The severity of substance abuse/dependence was moderate or higher requiring treatment was observed in 9 patients (36%). We found that differences in the severity of abuse/dependence and suicidal tendencies observed depending on the type of OTC drug. It is necessary for health care professionals to understand the characteristics of “young age,” “abuse/dependence,” and “suicidal tendencies” underlying overdose of OTC drugs, and to consider how to provide support for various difficulties in life under multidisciplinary cooperation.

In Japan, there has been a distressing surge in suicide rates, particularly among the youth and female populations, which is increasingly becoming a significant societal concern. In addition, changes in Japanese suicide patterns, observable in clinical traits of those taken to the Advanced Critical Care and Emergency Center following suicide attempts post-COVID-19, have been noted.

The object of this paper is to examine changes in the care of suicide attempters in general hospitals due to the COVID-19 epidemic. At our hospital, both the Advanced Critical Care and Emergency Center and the Department of Psychiatry provide care for suicide attempters, and the COVID-19 epidemic has brought about changes in the response in each department. Innovations in the care provided to those who attempt suicide include comprehensive family support at the Advanced Critical Care and Emergency Center and collaboration with related agencies at the Department of Psychiatry.

The COVID-19 epidemic also placed a heavy burden on medical personnel, and psychiatrists at general hospitals need to address the mental health of medical personnel as well.

One of the most important measures for suicide prevention is to prevent those who have attempted suicide from making subsequent attempts. Emergency medical staff, due to their role in emergency transport and care for suicide attempters, should develop expertise in managing these kinds of situations. In practice, however, opportunities for such education are very limited. The Japanese Society of Clinical Emergency Medicine has developed the PEEC (Psychiatric Evaluation in Emergency Care) course for initial response training dealing with psychiatric problems in emergency medical care settings. This training course has been conducted throughout Japan. However, the COVID-19 epidemic made it difficult to conduct the training in the same format as before. Therefore, we examined methods that would enable the course to be conducted even during the pandemic and began providing training in a new online format. Online training can be conducted without being affected by the status of COVID-19 in the community and has afforded several advantages. In the future, it will be necessary to verify whether online training provides the same benefits as face-to-face training. After that, either online training or face-to-face training can be chosen depending on conditions in the community, thereby potentially enabling the resumption of training throughout Japan.

Injection is a necessary medical procedure that everyone experiences at some point in their lives. However, it remains unclear how individuals visualize such injection procedures, thus rendering it difficult to examine specific preventive measures for learning about the excessive fear of needle. Therefore, we collected negative episodes regarding past injection procedures from 236 university students and automatically extracted the contents using a topic model, a natural language processing technique. Consequently, four types of experiences related to injection procedures were extracted, including “Attention to aversive information,” “Extended experience in mass vaccination,” “Knowledge transfer of medical information,” and “Collection of information on adverse events,” with “Extended experience in mass vaccination” and “Collection of information on adverse events” in particular being described as semantically close. These results led to a discussion on countermeasures against the fear of injections and yielded some important pointers to be kept in mind during injection procedures.

Delirium and behavioral and psychological symptoms of dementia (BPSD) occur frequently among elderly patients admitted to general hospitals. It is a major complication occurring throughout their physical treatment. Although antipsychotics are commonly used to treat delirium and BPSD, administration of oral or infusion drugs is challenging when a patient is physically unable to swallow or is in an excited or irritable condition. We studied patients with delirium or BPSD who received blonanserin transdermal patches, and determined the ratio of patients with effective treatment, details of side effects, and the factors associated with effectiveness. Of the 50 included patients, 34 (68%) showed improvement and 2 (4%) experienced side effects. Patients experiencing delirium without dementia showed significant improvement [adjusted odds ratio 0.22 (95%CI 0.05, 0.97)]. Our findings suggest that blonanserin transdermal patch will become a useful alternative in treating delirium and BPSD, if further research can confirm its efficacy and safety.

The perinatal management of an untreated schizophrenic pregnant patient presents many challenges. A female patient, diagnosed with schizophrenia at 35, went untreated for several years. Becoming pregnant at 37, she was indecisive between abortion and childbirth. She repeatedly visited the obstetric clinic for abortion but did not proceed with the procedure because of uncertainty. Early in pregnancy, multiple professionals including Child Guidance Center (CGC), obstetricians, pediatricians, and psychiatrists repeatedly held discussions to support her and counselled her to prevent child abuse. When the abortion window has closed, she decided to give birth; however, the psychotic symptoms worsened due to lack of treatment. After delivery, she was forced to commit to hospitalization and medication, following which her psychotic symptoms improved, and she accepted her child’s admission to the facility. Numerous professionals continued to support her for two years. She continued the treatment, following which her condition was stable. Finally, the CGC decided to integrate her child into her family. Herein, it was important to carefully consider the multidisciplinary approach to assist in decision-making and prevent abuse in schizophrenic pregnant patients.