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.