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Fraccalini T, Ricci V, Tarozzo B, Cardinale L, Primerano G, Kowsaralsadat M, Piccininni G, Boccuzzi A, Maina G, Volpicelli G. Effects of seasonality in emergency admissions for mental disorders: two years of clinical experience. Int J Psychiatry Clin Pract 2024; 28:45-52. [PMID: 38588530 DOI: 10.1080/13651501.2024.2331481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/06/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES This retrospective study, conducted in Turin, Italy, between January 2021 and February 2023, investigates the impact of seasonal heatwaves on emergency department (ED) admissions for mental disorders. METHODS Through the analysis of data from 2,854 patients, this research found a significant link between the occurrence of heatwaves, especially from June to August, and an elevated rate of ED admissions for psychiatric conditions. RESULTS The data indicate a clear seasonal pattern, with admissions peaking during the hot months and diminishing in the colder months. Particularly, the study delineates an enhanced correlation between heatwaves and admissions for severe psychiatric disorders, such as bipolar disorder, major depression, personality disorders, and schizophrenia, accounting for 1,868 of the cases examined. This correlation was most pronounced among individuals aged 50-59 years. CONCLUSIONS The results of this study highlight a critical association between the incidence of seasonal heatwaves and an uptick in ED visits for psychiatric disorders, with a distinct impact on severe cases. It underscores the urgency for healthcare systems to anticipate seasonal fluctuations in psychiatric ED admissions and to allocate resources effectively to support patients during peak periods.
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Affiliation(s)
- Thomas Fraccalini
- Department of Emergency Medicine, San Luigi Gonzaga University Hospital, Turin, Italy
| | - Valerio Ricci
- Department of Psychiatry, San Luigi Gonzaga University Hospital, Turin, Italy
| | | | - Luciano Cardinale
- Department of Oncology, Radiology Unit, San Luigi Gonzaga University Hospital, Turin, Italy
| | - Giuseppe Primerano
- Department of Aero-spatial Engineering, Politecnico of Turin, Turin, Italy
| | - Meraji Kowsaralsadat
- Graduation course, Faculty of Medicine and Surgery, University of Turin, Turin, Italy
| | - Giacomo Piccininni
- Graduation course, Faculty of Medicine and Surgery, University of Turin, Turin, Italy
| | - Adriana Boccuzzi
- Department of Emergency Medicine, San Luigi Gonzaga University Hospital, Turin, Italy
| | - Giuseppe Maina
- Department of Psychiatry, San Luigi Gonzaga University Hospital, Turin, Italy
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Giovanni Volpicelli
- Department of Emergency Medicine, San Luigi Gonzaga University Hospital, Turin, Italy
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Hu J, Feng Y, Su H, Xu Z, Ho HC, Zheng H, Zhang W, Tao J, Wu K, Hossain MZ, Zhang Y, Hu K, Huang C, Cheng J. Seasonal peak and the role of local weather in schizophrenia occurrence: A global analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 899:165658. [PMID: 37478950 DOI: 10.1016/j.scitotenv.2023.165658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Many studies have shown that the onset of schizophrenia peaked in certain months within a year and the local weather conditions could affect the morbidity risk of schizophrenia. This study aimed to conduct a systematic analysis of schizophrenia seasonality in different countries of the world and to explore the effects of weather factors globally. METHODS We searched three databases (PubMed, Web of Science, and China National Knowledge Infrastructure) for eligible studies published up to September 2022. Schizophrenia seasonality was compared between hemispheres and within China. A meta-analysis was conducted to pool excess risk (ER, absolute percentage increase in risk) of the onset of schizophrenia associated with various weather factors including temperature (an increase or decrease of temperature as a reflection of high or low temperature; heatwave; temperature variation), precipitation, etc. RESULTS: We identified 84 relevant articles from 22 countries, mainly in China. The seasonality analysis found that the onset of schizophrenia mostly peaked in the cold season in the southern hemisphere but in the warm season in the northern hemisphere. Interestingly in China, schizophrenia seasonality presented two peaks, respectively in the late cold and warm seasons. The meta-analysis further revealed an increased risk of schizophrenia after short-term exposure to high temperature [ER%: 0.45 % (95 % confidence interval (CI): 0.14 % to 0.76 %)], low temperature [ER%: 0.52 % (95%CI: 0.29 % to 0.75 %)], heatwave [ER%: 7.26 % (95%CI: 4.45 % to 10.14 %)], temperature variation [ER%: 1.02 % (95%CI: 0.55 % to 1.50 %)], extreme precipitation [ER%: 3.96 % (95%CI: 2.29 % to 5.67 %)]. The effect of other weather factors such as sunlight on schizophrenia was scarcely investigated with inconsistent findings. CONCLUSION This study provided evidence of intra- and inter-country variations in schizophrenia seasonality, especially the double-peak seasons in China. Exposure to local weather conditions mainly temperature changes and precipitation could affect the onset risk of schizophrenia.
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Affiliation(s)
- Jihong Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Yufan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Hung Chak Ho
- Department of Public and International Affairs, City University of Hong Kong, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Keyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China.
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Rizavas I, Gournellis R, Douzenis P, Efstathiou V, Bali P, Lagouvardos K, Douzenis A. A Systematic Review on the Impact of Seasonality on Severe Mental Illness Admissions: Does Seasonal Variation Affect Coercion? Healthcare (Basel) 2023; 11:2155. [PMID: 37570395 PMCID: PMC10418389 DOI: 10.3390/healthcare11152155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Coercion in psychiatry is associated mainly with involuntary admissions. The purpose of this study was to investigate the associations between hospital admissions of patients suffering from affective and schizophrenic disorders and seasonality. A systematic literature search using PubMed, Scopus and Google Scholar was conducted, including studies with affective and schizophrenia disorder admissions, published from October 1992 to August 2020. A total of 31 studies were included in the review. Four broad severe mental illness admission categories were identified regarding seasonality: affective disorders, schizophrenia disorders, involuntary admission affective disorders and involuntary admission schizophrenia disorders. There was clear and strong evidence for spring and summer peaks for severe mental illness admissions; data provided for age, gender and involuntary admissions was limited. Seasonality may have a significant effect on the onset and exacerbation of psychopathology of severe mental illness and should be considered as a risk factor in psychiatric admissions, violence and the risk of mental health coercion. A better understanding of the impact of seasonality on severe mental illness will help professionals to provide the best practices in mental health services in order to reduce and prevent psychiatric hospitalizations (especially involuntary admissions) resulting in further coercive measures.
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Affiliation(s)
- Ioannis Rizavas
- Psychiatric Hospital of Attica “Dafni”, 12462 Chaidari, Greece;
| | - Rossetos Gournellis
- Second Department of Psychiatry, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Chaidari, Greece; (R.G.); (A.D.)
| | - Phoebe Douzenis
- Medical School, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Vasiliki Efstathiou
- Postgraduate Program “Liaison Psychiatry Integrative Care of Physical and Mental Health”, School of Medicine, National and Kapodistrian University of Athens, 12462 Chaidari, Greece;
| | - Panagiota Bali
- Second Department of Psychiatry, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Chaidari, Greece; (R.G.); (A.D.)
| | - Kostas Lagouvardos
- National Observatory of Athens, Institute for Environmental Research and Sustainable Development, 15236 Athens, Greece;
| | - Athanasios Douzenis
- Second Department of Psychiatry, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Chaidari, Greece; (R.G.); (A.D.)
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Yao Y, Shi S, Li W, Luo B, Yang Y, Li M, Zhang L, Yuan X, Zhou X, Liu H, Zhang K. Seasonality of hospitalization for schizophrenia and mood disorders: A single-center cross-sectional study in China. J Affect Disord 2023; 323:40-45. [PMID: 36436764 DOI: 10.1016/j.jad.2022.11.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Seasonal patterns exist in many disorders and even serve as potential drivers of some disorders, but in schizophrenia and affective disorders, there is no uniform conclusion on the seasonal pattern. METHODS A total of 100,621 inpatients were surveyed in this study over 16 years, and 21,668 inpatients were ultimately included in the count after standard exclusion criteria were applied. RESULTS There was an uneven seasonal distribution of mental illness admissions (χ2 = 48.299, df = 18, P < .001). The peak of schizophrenia admissions occurred in the winter and the trough in the spring (52.6 % vs 50 %, P < .05). The peaks for depression and bipolar disorder were in the fall and spring, respectively, while the troughs were in the winter and fall, respectively (24.7 % vs 21.7 %, P < .05; 15.2 % vs 13.2 %, P < .05). Admissions for childhood mood disorders peaked in the fall (P < .05). We also found that the length of stay was also correlated with the season of admission, and that this seasonal fluctuation was not consistent across male and female populations. LIMITATIONS To avoid the effect of repeated hospitalizations, we maintained a registry of each patient's first admission only, which also resulted in our inability to explore the seasonal pattern of each disease recurrence at the individual level. CONCLUSIONS We found that the seasonal distribution of psychiatric admissions was not uniform. And there was also an uneven seasonal distribution of length of stay for patients admitted in different seasons. This may imply that certain environmental factors that vary with the seasons are potential drivers of mental illness.
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Affiliation(s)
- Yitan Yao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Shengya Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Wenfei Li
- Anhui Mental Health Center, Hefei 230022, China
| | - Bei Luo
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Xiaoping Yuan
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Xiaoqin Zhou
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China.
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, China.
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Rothschild J, Haase E. The mental health of women and climate change: Direct neuropsychiatric impacts and associated psychological concerns. Int J Gynaecol Obstet 2023; 160:405-413. [PMID: 36165632 DOI: 10.1002/ijgo.14479] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/11/2022] [Accepted: 09/26/2022] [Indexed: 01/20/2023]
Abstract
Climate change brings exposures to heat, air pollution, poorer quality food, and infectious disease that have significant direct effects on women and their mental health. These environmental impacts are multifaceted in their consequences and raise risks of depression, suicide, violent victimization, post-traumatic stress disorder, and various other neuropsychiatric symptoms. Women also suffer increased climate psychological risks from higher rates of stillbirth, preterm birth, and developmental problems in their children. Here we review what is known about the overlap of women's individual mental health and climate change, and highlight areas where more research is needed.
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Affiliation(s)
- Julia Rothschild
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Elizabeth Haase
- Department of Psychiatry, Carson Tahoe Regional Medical Center, Carson City, Nevada, USA.,University of Nevada School of Medicine at Reno, Reno, Nevada, USA
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Wang C, Qi Y, Chen Z. Explainable Gated Recurrent Unit to explore the effect of co-exposure to multiple air pollutants and meteorological conditions on mental health outcomes. ENVIRONMENT INTERNATIONAL 2023; 171:107689. [PMID: 36508748 DOI: 10.1016/j.envint.2022.107689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/03/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
Mental health conditions have the potential to be worsened by air pollution or other climate-sensitive factors. Few studies have empirically examined those associations when we faced to co-exposures, as well as interaction effects. There would be an urgent need to use deep learning to handle complex co-exposures that might interact in multiple ways, and the model performance reinforced by SHapely Additive exPlanations (SHAP) enabled our predictions interpretable and hence actionable. Here, to evaluate the mixed effect of short-term co-exposure, we conducted a time-series analysis using approximately 1.47 million hospital outpatient visits of mental disorders (i.e., depressive disorder-DD, Schizophrenia-SP, Anxiety Disorder-AD, Bipolar Disorder-BD, Attention Deficit and Hyperactivity Disorder-ADHD, Autism Spectrum Disorder-ASD), with matched meteorological observations from 2015 through 2019 in Nanjing, China. The global insights of gated recurrent unit model revealed that most of input features with similar effect size caused the illness risk of SP and ASD increase, and most markedly, 73% of relative humidity, 44.6 µg/m3 of NO2, and 14.1 µg/m3 of SO2 at 5-year average level associated with 2.27, 1.14, and 1.29 visits increase for DD, SP, and AD, respectively. Both synergic and antagonistic effect among informative paired-features were distinguished from local feature dependence. Interestingly, variation tendencies of excessive visits of bipolar disorder when atmospheric pressure, PM2.5, and O3 interacted with one another were inconsistent. Our results provided added qualitative and quantitative support for the conclusion that short-term co-exposure to ambient air pollutants and meteorological conditions posed threats to human mental health.
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Affiliation(s)
- Ce Wang
- School of Energy and Environment, Southeast University, Nanjing 210096, PR China; State Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing 210096, PR China.
| | - Yi Qi
- School of Architecture and Urban Planning, Nanjing University, No. 22 Hankoulu Road, Nanjing 210093, PR China
| | - Zhenhua Chen
- Department of Information, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing 210029, RP China.
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Ab Kader NI, Yusof UK, Khalid MNA, Nik Husain NR. Recent Techniques in Determining the Effects of Climate Change on Depressive Patients: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:1803401. [PMID: 35978588 PMCID: PMC9377838 DOI: 10.1155/2022/1803401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/03/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
Climate change is amongst the most serious issues nowadays. Climate change has become a concern for the scientific community as it could affect human health. Researchers have found that climate change potentially impacts human mental health, especially among depressive patients. However, the relationship is still unclear and needs further investigation. The purpose of this systematic review is to systematically evaluate the evidence of the association between climate change effects on depressive patients, investigate the effects of environmental exposure related to climate change on mental health outcomes for depressive patients, analyze the current technique used to determine the relationship, and provide the guidance for future research. Articles were identified by searching specified keywords in six electronic databases (Google Scholar, PubMed, Scopus, Springer, ScienceDirect, and IEEE Digital Library) from 2012 until 2021. Initially, 1823 articles were assessed based on inclusion criteria. After being analyzed, only 15 studies fit the eligibility criteria. The result from included studies showed that there appears to be strong evidence of the association of environmental exposure related to climate change in depressive patients. Temperature and air pollution are consistently associated with increased hospital admission of depressive patients; age and gender became the most frequently considered vulnerability factors. However, the current evidence is limited, and the output finding between each study is still varied and does not achieve a reasonable and mature conclusion regarding the relationship between the variables. Therefore, more evidence is needed in this domain study. Some variables might have complex patterns, and hard to identify the relationship. Thus, technique used to analyze the relationship should be strengthened to identify the relevant relationship.
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Affiliation(s)
- Nur Izzati Ab Kader
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Umi Kalsom Yusof
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Mohd Nor Akmal Khalid
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
- School of Information Science, Japan Advance Institute of Science and Technology, 1-1 Asahidai, Nomi 923-1292, Ishikawa, Japan
| | - Nik Rosmawati Nik Husain
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
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Nagarajan P, Rajkumar RP, Harichandrakumar KT, Varadharajan N. The pattern of inpatient psychiatry admissions at a general hospital psychiatry unit in South India: A retrospective study. Ind Psychiatry J 2022; 31:354-358. [PMID: 36419681 PMCID: PMC9678158 DOI: 10.4103/ipj.ipj_138_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/25/2021] [Accepted: 10/29/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Mental illnesses are becoming a major health issue across the world. The availability of inpatient facilities for mentally ill patients is very much limited in developing countries such as India. AIM This study was aimed to explore the pattern of psychiatric admissions at a general hospital psychiatry unit (GHPU) in South India. METHODOLOGY The study was conducted at a multispecialty tertiary care hospital in South India. A retrospective, chart-based study design was adopted to achieve the objectives. All inpatient case records available from the department of psychiatry, the medical records department, and the electronic hospital information system of the institute were reviewed between April 2006 and March 2016. RESULTS A total of 3082 patients were admitted as psychiatry inpatients during the 10-year study period, representing an average of 308.2 admissions per calendar year. The majority of inpatients were male (n = 1824; 59.2%). Concerning diagnostic categories, mood disorders were accounted for 33.6% of admissions, followed by psychotic disorders (26.4%) and substance use disorders (19.3%), respectively. The median length of hospital stay was 14 days (range 0-163 days). A statistically significant seasonality pattern was noticed for mood disorders (December to February) and anxiety and neurotic disorders (August to October). CONCLUSION It is obvious that treatment-seeking attitude among individuals with mental illnesses is increasing and the awareness regarding treatment aspects is also increasing among the general public. Hence, there is a need to improve the existing resources to facilitate intensive management for better treatment outcomes and this, in turn, will enhance the quality of life of mentally ill individuals.
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Affiliation(s)
- Padmavathi Nagarajan
- Department of Psychiatric Nursing, College of Nursing, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - K T Harichandrakumar
- Department of Bio-Statistics, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
| | - Natarajan Varadharajan
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
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Jahan S, Wraith D, Dunne MP, Naish S. Assessing evidence for seasonality of hospital admissions for schizophrenia in Queensland, Australia: a time series observational study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:2025-2035. [PMID: 34110485 DOI: 10.1007/s00484-021-02160-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 05/06/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
Most evidence on seasonal admission patterns for schizophrenia derives from the Northern Hemisphere with results from the Southern Hemisphere less documented. This study examines seasonal patterns in hospital admissions due to schizophrenia in Queensland, Australia, a large area that has a range of different climatic features. Daily hospital admissions data for people with the primary diagnosis of schizophrenia were collected from Queensland Health Department for the period from January 1996 to December 2015. A generalised linear regression model with Quasi-Poisson distribution was used to assess seasonal admission patterns across different climatic regions. The evidence for seasonality was also explored in subgroups that had different socio-demographic characteristics or history of prior hospitalisation for psychiatric disorders. Overall, a significant winter pattern (RR 1.05, 95%CI 1.01-1.13) was found with a peak in August (RR 1.08, 95%CI 1.03-1.17) in temperate Southeast Queensland. However, the hot humid North and Far North Queensland showed a peak in October (RR 1.10, 95%CI 1.02-1.22). Males (RR 1.11, 95%CI 1.07-1.14), people aged 40-59 years old (RR 1.10, 95%CI 1.05-1.15) and those who had never married (RR 1.09, 95%CI 1.06-1.12), were Australian by birth (RR 1.07, 95%CI 1.04-1.10) or were unemployed (RR 1.13, 95%CI 1.09-1.18) had significantly higher risk for hospital admissions, particularly during the winter months. The seasonal admission pattern for schizophrenia did not change significantly according to admission status and history of outpatient or community psychiatric treatment. The study found some evidence for seasonality of hospital admissions for schizophrenia that differed from northern tropical to southern temperate regions of Queensland.
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Affiliation(s)
- Shafkat Jahan
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
| | - Darren Wraith
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia
| | - Michael P Dunne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Suchithra Naish
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia
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Asimakopoulos LO, Koureta A, Benetou V, Lagiou P, Samoli E. Investigating the association between temperature and hospital admissions for major psychiatric diseases: A study in Greece. J Psychiatr Res 2021; 144:278-284. [PMID: 34710664 DOI: 10.1016/j.jpsychires.2021.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/13/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023]
Abstract
Evidence has emerged regarding the role of seasonality and several meteorological parameters on bipolar disorder, schizophrenia and depression. We investigated the relationship between ambient and apparent temperature and hospital admissions of major psychiatric diseases in a psychiatric clinic of a General Hospital situated in Northern Greece during 2013-19. Temperature data was provided by the National Observatory of Athens and diagnosis for psychotic, schizophrenic, manic and bipolar and unipolar depression were retrieved from medical records. A total of 783 admissions were recorded. Poisson regression models adjusted for time trends were applied to analyze the impact of temperature on monthly admissions. A summer peak was observed for the bipolar disorder, irrespectively of substance/alcohol use status. Seasonality emerged also for psychotic and schizophrenic patients with a through in winter. An increase of 1 °C in either ambient or apparent temperature was associated with an increase 1-2% in the monthly admissions in most outcomes under investigation. Alcohol and drug abuse did not modify this effect. Although our results indicate effects of temperature on psychiatric admissions, they are not consistent across subgroups populations and need to be replicated by other methodologically superior studies.
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Affiliation(s)
- Lampros Orion Asimakopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece; General Hospital of Katerini, Katerini, 60100, Central Macedonia, Greece.
| | - Anastasia Koureta
- General Hospital of Katerini, Katerini, 60100, Central Macedonia, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece
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Yoo EH, Eum Y, Roberts JE, Gao Q, Chen K. Association between extreme temperatures and emergency room visits related to mental disorders: A multi-region time-series study in New York, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148246. [PMID: 34144243 DOI: 10.1016/j.scitotenv.2021.148246] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is growing evidence suggesting that extreme temperatures have an impact on mental disorders. We aimed to explore the effect of extreme temperatures on emergency room (ER) visits for mental health disorders using 2.8 million records from New York State, USA (2009-2016), and to examine potential effect modifications by individuals' age, sex, and race/ethnicity through a stratified analysis to determine if certain populations are more susceptible. METHOD To assess the short-term impact of daily average temperature on ER visits related to mental disorders, we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, as well as long-term and seasonal time trends. We also conducted a meta-analysis to pool the region-specific risk estimates and construct the overall cumulative exposure-response curves for all regions. RESULTS We found positive associations between short-term exposure to extreme heat (27.07 ∘C) and increased ER visits for total mental disorders, as well as substance abuse, mood and anxiety disorders, schizophrenia, and dementia. We did not find any statistically significant difference among any subgroups of the population being more susceptible to extreme heat than any other. CONCLUSIONS Our findings suggest that there is a positive association between short-term exposure to extreme heat and increased ER visits for total mental disorders. This extreme effect was also found across all sub-categories of mental disease, although further research is needed to confirm our finding for specific mental disorders, such as dementia, which accounted for less than 1% of the total mental disorders in this sample.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, NY, USA
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Jahan S, Wraith D. Immediate and delayed effects of climatic factors on hospital admissions for schizophrenia in Queensland Australia: A time series analysis. ENVIRONMENTAL RESEARCH 2021; 197:111003. [PMID: 33716026 DOI: 10.1016/j.envres.2021.111003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/22/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Evidence of immediate and delayed effects of climatic drivers on hospital admissions for schizophrenia is limited and inconsistent. We aimed to assess the association between climatic factors and daily hospital admissions for schizophrenia in Queensland, Australia. METHODS Daily hospital admissions for schizophrenia from January 1, 1996 to December 31, 2015 in all private and public hospitals of Queensland were obtained from Queensland Health. The association between climatic factors and hospital admissions for schizophrenia were analysed using Generalised Linear Models with Poisson distribution (GLM) and Distributed Lag non-linear Models (DLNM) across different climatic zones. RESULTS In South East Queensland, only daily mean temperature showed an immediate negative effect on schizophrenia admissions (RR 0.93, 95%CI 0.90-0.98, p value < 0.001). For other regions, the adverse effect of temperature on hospital admissions was not significant, however, relative humidity (North: RR 1.01, 95%CI 1.00-1.02, p = 0.05) and air pressure (North: RR 1.03, 95%CI 1.00-1.05, p = 0.04; South West: RR 1.01, 95%CI 1.00-1.02, p = 0.05) had an immediate and positive effect on hospital admissions. Moreover, climatic factors had some delayed effects on schizophrenia admissions in different regions of Queensland, i.e. temperature over 0-4 lag days (South East: RR 0.97, 95%CI 0.94-0.98, p = 0.05; South West: RR 0.96, 95%CI 0.94-0.98, p = 0.01), relative humidity over 0-7 lag days (North: RR 0.95, 95%CI 0.92-0.98, p = 0.01; Central: RR 1.02, 95%CI 1.00-1.03, p = 0.05) and rainfall over 0-21 lag days (North: RR 1.03, 95%CI 1.01-1.04, p = 0.01). Meta-analysis showed significant pooled delayed effects of temperature (0-15 days lag: RR 0.95, 95% CI 0.93-0.98, p value < 0.001), relative humidity (0-7 days: RR 0.96, 95%CI 0.92-0.99, p < 0.001); rainfall (0-21 lag days: RR 1.03, 95%CI 1.01-1.04, p < 0.001) and air pressure (0-7 days lag: RR 1.02, 95%CI 1.00-1.04, p < 0.001) on schizophrenia admissions in Queensland. DISCUSSION As this is the largest study from Australia and also internationally to extensively examine both short term and delayed association between climatic factors and daily admissions for schizophrenia, the results of the study indicate that climate plays an important role in the sudden exacerbation of acute episodes of schizophrenia. Thus, preventive measures could be taken to reduce the severity of symptoms as well as hospital admissions due to schizophrenia during vulnerable periods.
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Affiliation(s)
- Shafkat Jahan
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Queensland, Australia.
| | - Darren Wraith
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Queensland, Australia
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Llanes-Álvarez C, Alberola-López C, Andrés-de-Llano JM, Álvarez-Navares AI, Pastor-Hidalgo MT, Roncero C, Garmendia-Leiza JR, Franco-Martín MA. Hospitalization trends and chronobiology for mental disorders in Spain from 2005 to 2015. Chronobiol Int 2020; 38:286-295. [PMID: 32869668 DOI: 10.1080/07420528.2020.1811719] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Rhythm research has had a long tradition in psychiatry, especially in affective disorders. The study of trends in incidence plays a central role in epidemiology and public health. The aims of this research were to describe the socio-demographic and clinical characteristics of persons admitted for psychiatric hospitalization and their trends and periodicity in cases (global and by groups) in Spain over the 11 year study span. We conducted a cross-sectional study of the hospital discharge database of Castilla y León from 2005 to 2015, selecting hospitalizations for psychiatric reasons. Trends in the rates of hospitalization were studied by joinpoint regression analysis. Time series analysis for periodicities was done by spectral analysis, fast Fourier transform, and cosinor analysis. Some 49501 hospitalizations due to psychiatric disorders, out of 2717192 hospital admissions, took place during the study span. Hospitalizations for psychosis were frequent (15949, 32.2%), while such for eating disorders were infrequent, but showed the highest average stay (28 days) and DRG relative weight (2.41). The general trend was a statistically significant 2% annual increase in psychiatric hospitalizations over the 11 year span; substance abuse was the only exception to this trend. The whole population and the subgroups of psychosis and bipolar disorders showed significant circannual (one-year) variation in admissions. The rhythm percentage of the global group was 11.4%, while the rhythm percentages of the psychosis, bipolar, and eating disorders were 17.1%, 17.5%, and 9.6%, respectively (p < .05).
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Affiliation(s)
| | - Carlos Alberola-López
- Image Processing Laboratory, ETSI Telecommunication, University of Valladolid , Valladolid, Spain
| | | | - Ana I Álvarez-Navares
- Department of Psychiatry, Salamanca University Health Care Complex , Salamanca, Spain
| | | | - Carlos Roncero
- Department of Psychiatry, Salamanca University Health Care Complex , Salamanca, Spain
| | - José R Garmendia-Leiza
- General Direction of Information Systems, Quality and Pharmaceutical Provision at Castilla y León Health Authority, Regional Health Management , Valladolid, Spain
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14
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Jahan S, Wraith D, Dunne MP, Naish S, McLean D. Seasonality and schizophrenia: a comprehensive overview of the seasonal pattern of hospital admissions and potential drivers. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1423-1432. [PMID: 32281005 DOI: 10.1007/s00484-020-01910-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
Schizophrenia is a severe neuropsychiatric disorder with heterogeneous aetiology mostly affecting younger people and causing immense disability. Seasonal patterns may be observed in schizophrenia hospital admissions with possible association with changing climatic parameters and socio-demographic characteristics. This study critically reviewed studies that have assessed seasonal variations of hospital admissions for schizophrenia and/or explored an association with climate parameters and/or other potential factors. Following PRISMA guidelines, a systematic literature search was conducted using electronic databases (e.g. MEDLINE, Science Direct, PsycINFO, Pub Med) from inception to February 29, 2020. Thirty five papers were identified, of which only six (17.1%) examined evidence for a seasonal pattern or monthly excess of hospital admissions and the remaining twenty nine (82.9%) assessed climatic and socio-demographic attributes relating to the seasonal pattern or increased hospitalisation for schizophrenia. While most studies reported a summer peak in hospital admission rates, other studies reported a winter peak. Most of the evidence indicated that higher temperatures (> 28 °C) were positively correlated with schizophrenia admission rates. The individual effects of other climatic parameters (e.g. relative humidity, rainfall, atmospheric pressure, sunlight) were less frequently assessed. Males, people of 21-60 years old, and those married were more vulnerable to climatic variability specifically to higher temperatures. Further studies using large sample sizes, analysis of a wide range of interacting environmental variables and sophisticated statistical approaches are needed to better understand the underlying mechanisms involved. This will also provide more reliable statistical evidence that will help in the prevention and better management of cases.
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Affiliation(s)
- Shafkat Jahan
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Queensland, 4059, Australia.
| | - Darren Wraith
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Queensland, 4059, Australia
| | - Michael P Dunne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Suchithra Naish
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Queensland, 4059, Australia
| | - Duncan McLean
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Research and Education, Brisbane, Queensland, 4076, Australia
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Hinterbuchinger B, König D, Gmeiner A, Listabarth S, Fellinger M, Thenius C, Baumgartner JS, Vyssoki S, Waldhoer T, Vyssoki B, Pruckner N. Seasonality in schizophrenia-An analysis of a nationwide registry with 110,735 hospital admissions. Eur Psychiatry 2020; 63:e55. [PMID: 32389135 PMCID: PMC7355169 DOI: 10.1192/j.eurpsy.2020.47] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background. Seasonal patterns in hospitalizations have been observed in various psychiatric disorders, however, it is unclear whether they also exist in schizophrenia. Previous studies found mixed results and those reporting the presence of seasonality differ regarding the characteristics of these patterns. Further, they are inconclusive whether sex is an influencing factor. The aim of this study was therefore to examine if seasonal patterns in hospitalizations can be found in schizophrenia, with special regard to a possible influence of sex, by using a large national dataset. Methods. Data on all hospital admissions within Austria due to schizophrenia (F20.0–F20.6) for the time period of 2003–2016 were included. Age standardized monthly variation of hospitalization for women and men was analyzed and the level of significance adjusted for multiple testing. Results. The database comprised of 110,735 admissions (59.6% men). Significant seasonal variations were found in the total sample with hospitalization peaks in January and June and a trough in December (p < 0.0001). No significant difference in these patterns was found between women and men with schizophrenia (p < 0.0001). Conclusion. Our study shows that schizophrenia-related hospitalizations follow a seasonal pattern in both men and women. The distribution of peaks might be influenced by photoperiod changes which trigger worsening of symptoms and lead to exacerbations in schizophrenia. Further research is necessary to identify underlying factors influencing seasonal patterns and to assess whether a subgroup of patients with schizophrenia is especially vulnerable to the impact of seasonal variations.
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Affiliation(s)
- B Hinterbuchinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - D König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - A Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - S Listabarth
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - M Fellinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - C Thenius
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - J S Baumgartner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - S Vyssoki
- Department of Health Sciences, University of Applied Sciences, St. Pölten, Austria
| | - T Waldhoer
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - B Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - N Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Cheng S, Buckley NA, Siu W, Chiew AL, Vecellio E, Chan BS. Seasonal and temperature effect on serum lithium concentrations. Aust N Z J Psychiatry 2020; 54:282-287. [PMID: 31782314 DOI: 10.1177/0004867419889160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lithium remains the gold standard treatment for bipolar disorder. However, it has a very narrow therapeutic index (0.6-0.8 mmol/L). It has been suggested that high environmental temperature can lead to dehydration, elevated plasma lithium concentration and then lithium toxicity. OBJECTIVES We aimed to investigate the effect of seasonal and short-term changes in temperature on serum lithium concentrations in Sydney, Australia. METHODS We retrospectively analysed data from all patients who had serum lithium concentrations taken from the Prince of Wales and Sutherland Hospitals between 2008 and 2018. Temperature data came from the Bureau of Meteorology. We examined correlations between lithium concentrations and the preceding 5 days maximum temperatures, month and season. We also performed a longitudinal analysis of the effect of temperature and seasons within selected patients who had repeated levels. RESULTS A total of 11,912 serum lithium concentrations from 2493 patients were analysed. There was no significant association between higher lithium concentration and preceding higher temperatures (r = -0.008, p = 0.399). There was also no important seasonal or monthly variation, across all patients or in the smaller cohort with longitudinal data (n = 123, r = 0.008, 95% confidence interval: [-0.04, 0.06]). CONCLUSION There were no clinically important differences in serum lithium concentration related to seasons, months or temperatures, which suggests that patients on lithium are able to adequately maintain hydration during hot weather in Sydney.
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Affiliation(s)
- Sonia Cheng
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Nicholas A Buckley
- Department of Clinical Pharmacology, The University of Sydney, Sydney, NSW, Australia
| | - William Siu
- Emergency Department, Sutherland Hospital, Sydney, NSW, Australia
| | - Angela L Chiew
- Department of Emergency Medicine & Clinical Toxicology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Elia Vecellio
- NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Betty S Chan
- Department of Emergency Medicine & Clinical Toxicology, Prince of Wales Hospital, Sydney, NSW, Australia
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17
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Altun A, Brown H, Szoeke C, Goodwill AM. The Mediterranean dietary pattern and depression risk: A systematic review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.npbr.2019.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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18
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Gu S, Huang R, Yang J, Sun S, Xu Y, Zhang R, Wang Y, Lu B, He T, Wang A, Bian G, Wang Q. Exposure-lag-response association between sunlight and schizophrenia in Ningbo, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 247:285-292. [PMID: 30685669 DOI: 10.1016/j.envpol.2018.12.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 12/08/2018] [Accepted: 12/09/2018] [Indexed: 06/09/2023]
Abstract
Previous studies found that mental disorders such as bipolar disorder, seasonal affective disorder and schizophrenia, often show seasonal variability, which usually be attributed to the variations in the number of natural sunlight. However, few studies have been conducted on the acute effects of exposure to sunlight on the onset of these disease. The aim of this study was to evaluate the exposure-response relationship between sunshine duration and the hospital admissions for schizophrenia. We obtained data on hospital admissions for schizophrenia from the largest psychiatric hospital in Ningbo, China, during 2012-2016. A Distributed lag non-linear model was used to estimate the exposure-lag-response relationship between sunlight and schizophrenia. We calculated the effects of short and long sunshine duration, defined using the cutoffs at the 1st and 99th sunshine duration percentiles. We detected significant and non-linear associations between sunlight and schizophrenia, and the overall estimated relative risk (RR) for a lag of 0-21 days was 1.45 (95% CI: 1.07, 1.97) and 1.41(95% CI: 0.72, 2.75) for short and long sunshine duration, respectively. The burden of schizophrenia was greater during periods with short sunshine duration than during periods with long sunshine duration, with the AFs of 19.94% (95% CI: 8.65%, 28.24%) and 2.12% (95% CI: -2.70%, 5.57%), respectively. The female and people more than 45 years old were most susceptible to these effects. We repeated our analysis by using global solar radiation as a continuous exposure variable of sunlight intensity in the model, and the result shows that the female and middle-aged and eldly patients were also susceptible to the effects of low levels of global solar radiation. Our findings suggest that there may be a relationship between lack of exposure to sunlight and increased risk of hospital admissions for schizophrenia. Policymakers and doctors should promote further understanding of the health benefits of sunlight and take effective measures to prevent schizophrenia.
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Affiliation(s)
- Shaohua Gu
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315010, China.
| | - Ruixue Huang
- Xiangya School of Public Health, Central South University, Hunan, 361000, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 510000, China.
| | - Shiqiang Sun
- Ningbo Meteorological Bureau, Ningbo, 315000, China.
| | - Yiner Xu
- Ningbo Kangning Hospital, Ningbo, 315000, China.
| | | | - Yunfeng Wang
- Ningbo Kangning Hospital, Ningbo, 315000, China.
| | - Beibei Lu
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315010, China.
| | - Tianfeng He
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315010, China.
| | - Aihong Wang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315010, China.
| | - Guolin Bian
- Ningbo Kangning Hospital, Ningbo, 315000, China.
| | - Qunli Wang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315010, China.
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Wortzel JR, Norden JG, Turner BE, Haynor DR, Kent ST, Al-Hamdan MZ, Avery DH, Norden MJ. Ambient temperature and solar insolation are associated with decreased prevalence of SSRI-treated psychiatric disorders. J Psychiatr Res 2019; 110:57-63. [PMID: 30594025 DOI: 10.1016/j.jpsychires.2018.12.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/02/2018] [Accepted: 12/12/2018] [Indexed: 12/31/2022]
Abstract
Serotonergic function is known to fluctuate in association with light and temperature. Serotonin-related behaviors and disorders similarly vary with climatic exposure, but the associations are complex. This complexity may reflect the importance of dose and timing of exposure, as well as acclimation. This cross-sectional study tests how average climate exposures (ambient temperature and solar insolation) vary with the prevalence of a group of SSRI-treated disorders. For comparison, we similarly studied a group of disorders not treated by SSRIs (i.e substance use disorders). Psychiatric prevalence data were obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES). Average yearly solar insolation was obtained from NASA's NLDAS-2 Forcing Dataset Information. Average yearly temperature was obtained from NOAA's US Climate Normals. Logistic regression models were generated to assess the relationship between these two climatic factors and the prevalence of SSRI-treated and substance use disorders. Age, gender, race, income, and education were included in the models to control for possible confounding. Temperature and insolation were significantly associated with the SSRI-responsive group. For an average 1 GJ/m2/year increase, OR was 0.90 (95% CI 0.85-0.96, p = 0.001), and for an average 10 °F increase, OR was 0.93 (95% CI 0.88-0.97, p = 0.001). This relationship was not seen with substance use disorders (insolation OR: 0.97, p = 0.682; temperature OR: 0.96, p = 0.481). These results warrant further investigation, but they support the hypothesis that chronic exposure to increased temperature and light positively impact serotonin function, and are associated with reduced prevalence of some psychiatric disorders. They also support further investigation of light and hyperthermia treatments.
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Affiliation(s)
- J R Wortzel
- School of Medicine, Stanford University, Stanford, CA, 94305, USA.
| | - J G Norden
- School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - B E Turner
- School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - D R Haynor
- University of Washington, Seattle, WA, 98195, USA
| | - S T Kent
- School of Public Health, University of Alabama at Birmingham Universities, AL, 35294, USA
| | - M Z Al-Hamdan
- Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL, 35812, USA
| | - D H Avery
- University of Washington, Seattle, WA, 98195, USA
| | - M J Norden
- University of Washington, Retired Associate Professor on the Axillary Faculty, USA
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20
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He Y, Zhang X, Ren M, Bao J, Huang C, Hajat S, Barnett AG. Assessing Effect Modification of Excess Winter Death by Causes of Death and Individual Characteristics in Zhejiang Province, China: A Multi-Community Case-Only Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1663. [PMID: 30082621 PMCID: PMC6121352 DOI: 10.3390/ijerph15081663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/18/2022]
Abstract
Mortality in many parts of the world has a seasonal pattern, with a marked excess of deaths during winter. To date, however, there is very little published evidence on the nature of this wintertime excess in low- and middle-income countries. In this study, we aimed to quantify the extent of the death peak in winter and to assess effect modification on excess winter death (EWD) by individual characteristics and cause of deaths in China. We used a Cosinor model to examine seasonal patterns for specific causes of deaths and a case-only analysis of deaths in winter compared with other seasons to assess effect modification by individual characteristics. A total of 398,529 deaths were investigated between January 2010 and December 2013 in Zhejiang Province, China. Deaths peaked in winter, and overall mortality was around 30% higher in winter than in summer. Although diseases of the respiratory and circulatory systems were highly seasonal, surprisingly we observed that deaths from mental and behavioral disorders exhibited greater fluctuation. Males, the elderly and illiterate individuals suffered high EWD. EWDs were also particularly common in emergency rooms, at home, on the way to hospitals, and in nursing homes/family wards. This study highlighted the high EWD in some previously unreported groups, indicating new information to facilitate the targeting of necessary preventive measures to those at greatest risk in order to mitigate wintertime death burdens.
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Affiliation(s)
- Yiling He
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 31004, China.
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Shakoor Hajat
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland 4059, Australia.
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21
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Henriksson HE, White RA, Sylvén SM, Papadopoulos FC, Skalkidou A. Meteorological parameters and air pollen count in association with self-reported peripartum depressive symptoms. Eur Psychiatry 2018; 54:10-18. [PMID: 30031991 DOI: 10.1016/j.eurpsy.2018.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/25/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Meteorological parameters and air pollen count have been associated with affective disorders and suicide. Regarding peripartum depression, the literature is restricted and inconclusive. METHODS This cross-sectional study included women (pregnant, n = 3843; postpartum, n = 3757) who participated in the BASIC (Biology, Affect, Stress, Imaging, and Cognition) study 2010-2015 and the UPPSAT (Uppsala-Athens) study (postpartum, n = 1565) in 2006-2007. Cases were defined according to presence of depressive symptoms during pregnancy (gestational week 32) and 6 weeks postpartum, using the Edinburgh Postnatal Depression Scale (EPDS). Exposure of sunshine, temperature, precipitation, snow coverage, and air pollen counts of durations of 1, 7, and 42 days prior to the outcome were studied for associations with depressive symptoms, using negative binomial regression. RESULTS Prior to Bonferroni correction, the concentration of mugwort pollen, both one week and six weeks before the EPDS assessment at gestational week 32, was inversely associated with depressive symptoms in pregnancy, both before and after adjustment for season. No associations were found between the exposure to meteorological parameters and pollen and depressive symptoms, at the same day of depressive symptoms' assessment, the previous week, or the six weeks prior to assessment, either during pregnancy or postpartum after Bonferroni correction. CONCLUSIONS There was no evidence that neither short-term nor long-term exposure to meteorological parameters or air pollen counts were associated with self-reported peripartum depressive symptoms in Uppsala, Sweden.
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Affiliation(s)
- Hanna E Henriksson
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 75185, Uppsala, Sweden.
| | | | - Sara M Sylvén
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 75185, Uppsala, Sweden; Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 75185, Uppsala, Sweden
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Brandl EJ, Lett TA, Bakanidze G, Heinz A, Bermpohl F, Schouler-Ocak M. Weather conditions influence the number of psychiatric emergency room patients. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:843-850. [PMID: 29204686 DOI: 10.1007/s00484-017-1485-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/17/2017] [Accepted: 11/27/2017] [Indexed: 06/07/2023]
Abstract
The specific impact of weather factors on psychiatric disorders has been investigated only in few studies with inconsistent results. We hypothesized that meteorological conditions influence the number of cases presenting in a psychiatric emergency room as a measure of mental health conditions. We analyzed the number of patients consulting the emergency room (ER) of a psychiatric hospital in Berlin, Germany, between January 1, 2008, and December 31, 2014. A total of N = 22,672 cases were treated in the ER over the study period. Meteorological data were obtained from a publicly available data base. Due to collinearity among the meteorological variables, we performed a principal component (PC) analysis. Association of PCs with the daily number of patients was analyzed with autoregressive integrated moving average model. Delayed effects were investigated using Granger causal modeling. Daily number of patients in the ER was significantly higher in spring and summer compared to fall and winter (p < 0.001). Three PCs explained 76.8% percent of the variance with PC1 loading mostly on temperature, PC2 on cloudiness and low pressure, and PC3 on windiness. PC1 and PC2 showed strong association with number of patients in the emergency room (p < 0.010) indicating higher patient numbers on warmer and on cloudy days. Further, PC1, PC2, and PC3 predicted the number of patients presenting in the emergency room for up to 7 days (p < 0.050). A secondary analysis revealed that the effect of temperature on number of patients was mostly due to lower patient numbers on cold days. Although replication of our findings is required, our results suggest that weather influences the number of psychiatric patients consulting the emergency room. In particular, our data indicate lower patient numbers during very cold temperatures.
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Affiliation(s)
- Eva Janina Brandl
- Psychiatric University Hospital of Charité at St. Hedwig-Hospital, Große Hamburger Str. 5-11, 10115, Berlin, Germany.
- Berlin Institute of Health, Berlin, Germany.
| | - Tristram A Lett
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - George Bakanidze
- Psychiatric University Hospital of Charité at St. Hedwig-Hospital, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - Andreas Heinz
- Psychiatric University Hospital of Charité at St. Hedwig-Hospital, Große Hamburger Str. 5-11, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Felix Bermpohl
- Psychiatric University Hospital of Charité at St. Hedwig-Hospital, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - Meryam Schouler-Ocak
- Psychiatric University Hospital of Charité at St. Hedwig-Hospital, Große Hamburger Str. 5-11, 10115, Berlin, Germany
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Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040754. [PMID: 29662001 PMCID: PMC5923796 DOI: 10.3390/ijerph15040754] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/06/2018] [Accepted: 04/12/2018] [Indexed: 11/16/2022]
Abstract
Background: Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods: Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results: 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion: This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.
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Effect of increasing temperature on daily hospital admissions for schizophrenia in Hefei, China: a time-series analysis. Public Health 2018; 159:70-77. [PMID: 29567010 DOI: 10.1016/j.puhe.2018.01.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/25/2017] [Accepted: 01/30/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the relationship between ambient temperature and hospital admissions for schizophrenia in Hefei, China. STUDY DESIGN An ecological design was used to explore the effect of ambient temperature on hospital admissions for schizophrenia. METHODS Daily data on hospital admissions for schizophrenia and meteorological data for the warm season (May-October) in 2005-2014 were obtained from Anhui Mental Health Centre and Hefei Bureau of Meteorology, respectively. Poisson generalised linear regression model combined with a distributed lag non-linear model was used to analyse the effects of temperature on admissions for schizophrenia. Stratified analyses according to individual characteristics, such as age and sex, were also conducted. RESULTS A significant relationship was found between ambient temperature and admissions for schizophrenia. High temperature appeared to have a delayed effect on admissions for schizophrenia, and a temperature of 28°C (75th percentile) at lag 0-4 days was associated with a 7% (95% confidence interval: 4-11%) increase in admissions for schizophrenia. Stratified analyses showed that male patients, patients aged 21-60 years and married patients were more vulnerable to high temperature, and the temperature effects for those groups occurred at a lag of 1 day. CONCLUSION High temperature poses significant risks for schizophrenia in subtropical regions. Future preventive measures for reducing the occurrence of schizophrenia should be considered for susceptible populations.
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Aguglia A, Borsotti A, Cuniberti F, Serafini G, Amore M, Maina G. The influence of sunlight exposure on hospitalization in emergency psychiatry. Chronobiol Int 2017; 34:1413-1422. [DOI: 10.1080/07420528.2017.1374286] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- “Rita Levi Montalcini” Department of Neuroscience, University of Turin, Turin, Italy
| | - Antonio Borsotti
- Psychiatric Clinic, “S Luigi Gonzaga Hospital” of Orbassano – “Rita Levi Montalcini” Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesco Cuniberti
- Psychiatric Clinic, “S Luigi Gonzaga Hospital” of Orbassano – “Rita Levi Montalcini” Department of Neuroscience, University of Turin, Turin, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Giuseppe Maina
- Psychiatric Clinic, “S Luigi Gonzaga Hospital” of Orbassano – “Rita Levi Montalcini” Department of Neuroscience, University of Turin, Turin, Italy
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Aguglia A, Borsotti A, Maina G. Bipolar disorders: is there an influence of seasonality or photoperiod? ACTA ACUST UNITED AC 2017; 40:6-11. [PMID: 28614493 PMCID: PMC6899423 DOI: 10.1590/1516-4446-2016-2144] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/25/2017] [Indexed: 11/25/2022]
Abstract
Objective: To increase understanding of the influence of photoperiod variation in patients with bipolar disorders. Methods: We followed a sample of Italian bipolar patients over a period of 24 months, focusing on inpatients. All patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital in Orbassano (Turin, Italy) between September 1, 2013 and August 31, 2015 were recruited. Sociodemographic and clinical data were collected. Results: Seven hundred and thirty patients were included. The admission rate for bipolar patients was significantly higher during May, June and July, when there was maximum sunlight exposure, although no seasonal pattern was found. Patients with (hypo)manic episodes were admitted more frequently during the spring and during longer photoperiods than those with major depressive episodes. Conclusions: Photoperiod is a key element in bipolar disorder, not only as an environmental factor but also as an important clinical parameter that should be considered during treatment.
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Affiliation(s)
- Andrea Aguglia
- Dipartimento di Neuroscienze Rita Levi Montalcini, Ospedale San Luigi Gonzaga, Università degli Studi di Torino, Orbassano, Turin, Italy
| | - Antonio Borsotti
- Dipartimento di Neuroscienze Rita Levi Montalcini, Ospedale San Luigi Gonzaga, Università degli Studi di Torino, Orbassano, Turin, Italy
| | - Giuseppe Maina
- Dipartimento di Neuroscienze Rita Levi Montalcini, Ospedale San Luigi Gonzaga, Università degli Studi di Torino, Orbassano, Turin, Italy
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Haimovich JS, Venkatesh AK, Shojaee A, Coppi A, Warner F, Li SX, Krumholz HM. Discovery of temporal and disease association patterns in condition-specific hospital utilization rates. PLoS One 2017; 12:e0172049. [PMID: 28355219 PMCID: PMC5371293 DOI: 10.1371/journal.pone.0172049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/30/2017] [Indexed: 11/18/2022] Open
Abstract
Identifying temporal variation in hospitalization rates may provide insights about disease patterns and thereby inform research, policy, and clinical care. However, the majority of medical conditions have not been studied for their potential seasonal variation. The objective of this study was to apply a data-driven approach to characterize temporal variation in condition-specific hospitalizations. Using a dataset of 34 million inpatient discharges gathered from hospitals in New York State from 2008-2011, we grouped all discharges into 263 clinical conditions based on the principal discharge diagnosis using Clinical Classification Software in order to mitigate the limitation that administrative claims data reflect clinical conditions to varying specificity. After applying Seasonal-Trend Decomposition by LOESS, we estimated the periodicity of the seasonal component using spectral analysis and applied harmonic regression to calculate the amplitude and phase of the condition's seasonal utilization pattern. We also introduced four new indices of temporal variation: mean oscillation width, seasonal coefficient, trend coefficient, and linearity of the trend. Finally, K-means clustering was used to group conditions across these four indices to identify common temporal variation patterns. Of all 263 clinical conditions considered, 164 demonstrated statistically significant seasonality. Notably, we identified conditions for which seasonal variation has not been previously described such as ovarian cancer, tuberculosis, and schizophrenia. Clustering analysis yielded three distinct groups of conditions based on multiple measures of seasonal variation. Our study was limited to New York State and results may not directly apply to other regions with distinct climates and health burden. A substantial proportion of medical conditions, larger than previously described, exhibit seasonal variation in hospital utilization. Moreover, the application of clustering tools yields groups of clinically heterogeneous conditions with similar seasonal phenotypes. Further investigation is necessary to uncover common etiologies underlying these shared seasonal phenotypes.
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Affiliation(s)
- Julian S. Haimovich
- Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Arjun K. Venkatesh
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Abbas Shojaee
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America
| | - Andreas Coppi
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America
| | - Frederick Warner
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America
| | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- The Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America
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Hoffmann K, Haussleiter IS, Illes F, Jendreyschak J, Diehl A, Emons B, Armgart C, Schramm A, Juckel G. Preventing involuntary admissions: special needs for distinct patient groups. Ann Gen Psychiatry 2017; 16:3. [PMID: 28174594 PMCID: PMC5290643 DOI: 10.1186/s12991-016-0125-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 12/30/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Coercive measures in psychiatry are a controversial topic and raise ethical, legal and clinical issues. Involuntary admission of patients is a long-lasting problem and indicates a problematic pathway to care situations within the community, largely because personal freedom is fundamentally covered by the UN declaration of human rights and the German constitution. METHODS In this study, a survey on a large and comprehensive population of psychiatric in-patients in the eastern part of North Rhine-Westphalia, Germany, was carried out for the years 2004-2009, including 230.678 treatment cases. The data were collected from the dataset transferred to health insurance automatically, which, since 2004 is available in an electronic form. In addition, a wide variety of information on treatment, sociodemographic and illness-related factors were collected and analysed. Data were collected retrospectively and analyses were calculated using statistical software (IBM SPSS Statistics 19.0®). Quantitative data are presented as mean and standard deviation. Due to the unequal group sizes, group differences were calculated by means of Chi-square tests or independent sample t tests. A Bonferroni correction was applied to control for multiple comparisons. RESULTS We found an over-representation of involuntary admissions in young men (<21 years) suffering from schizophrenia and in female patients aged over 60 with a diagnosis of dementia. Most of our results are concordant with the previous literature. Also admission in hours out of regular out-patient services elevated the risk. CONCLUSION The main conclusion from these findings is a need for a fortification of ambulatory treatment offers, e.g. sociopsychiatric services or ward round at home for early diagnosis and intervention. Further prospective studyies are needed.
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Affiliation(s)
- Knut Hoffmann
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany.,Department of Psychiatry, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - I S Haussleiter
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany
| | - F Illes
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany.,Department of Psychiatry, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - J Jendreyschak
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany.,Department of Psychiatry, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - A Diehl
- NRW Center for Health, Gesundheitscampus 9, 44801 Bochum, Germany
| | - B Emons
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany
| | - C Armgart
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany
| | - A Schramm
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany
| | - G Juckel
- Dept. of Psychiatry, LWL Institute of Mental Health, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791 Bochum, Germany.,Department of Psychiatry, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
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Aguglia A, Moncalvo M, Solia F, Maina G. Involuntary admissions in Italy: the impact of seasonality. Int J Psychiatry Clin Pract 2016; 20:232-8. [PMID: 27551753 DOI: 10.1080/13651501.2016.1214736] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of this study is to assess the prevalence of involuntary admissions with regard to seasonality and clinical associated features, in a sample of patients admitted to a psychiatric unit in a period of 24 months. METHODS All subjects consecutively admitted to the Psychiatric Inpatient Unit of the San Luigi Gonzaga Hospital, Orbassano (University of Turin, Italy) from September 2013 to August 2015 were recruited. Socio-demographic and clinical characteristics were collected. RESULTS Seven hundred and thirty admissions in psychiatric ward were recognized. The prevalence of involuntary admission was 15.4%. Patients with involuntary hospitalizations showed a higher education level, a higher prevalence of admission in spring/summer with a significant peak in June, a longer duration of hospitalization and a lower suicide ideation. Among involuntary admissions, physical restraint and suicide attempts were more prevalent during spring compared to the other seasons. CONCLUSIONS Seasonality has an important role in the psychopathology of psychiatric disorders, particularly in bipolar and related disorder, and may represent an influencing factor in hospital admissions and hospitalizations. Seasonal pattern must be considered while managing diagnosis and treatment of mental disorders, with regard to prevention and psychoeducation of patients.
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Affiliation(s)
- Andrea Aguglia
- a Department of Neuroscience, Psychiatric Unit, S Luigi Gonzaga Hospital , University of Turin , Turin , Italy
| | - Marta Moncalvo
- a Department of Neuroscience, Psychiatric Unit, S Luigi Gonzaga Hospital , University of Turin , Turin , Italy
| | - Francesca Solia
- a Department of Neuroscience, Psychiatric Unit, S Luigi Gonzaga Hospital , University of Turin , Turin , Italy
| | - Giuseppe Maina
- a Department of Neuroscience, Psychiatric Unit, S Luigi Gonzaga Hospital , University of Turin , Turin , Italy
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Trang PM, Rocklöv J, Giang KB, Nilsson M. Seasonality of hospital admissions for mental disorders in Hanoi, Vietnam. Glob Health Action 2016; 9:32116. [PMID: 27566716 PMCID: PMC5002036 DOI: 10.3402/gha.v9.32116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/30/2016] [Accepted: 07/15/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some studies have shown a relationship between seasonality in weather patterns and depressive and behavioural disorders, especially in temperate climate regions. However, there is a lack of studies describing the seasonal patterns of hospital admissions for a variety of mental disorders in tropical and subtropical nations. The aim of this study has been to examine the relationship between seasons and daily hospital admissions for mental disorders in Hanoi, Vietnam. DESIGNS A 5-year database (2008-2012) compiled by Hanoi Mental Hospital covering mental disorder admissions diagnosed by the International Classification of Diseases 10 was analysed. A negative binominal regression model was applied to estimate the associations between seasonality and daily hospital admissions for mental disorders, for all causes and for specific diagnoses. RESULTS The summer season indicated the highest relative risk (RR=1.24, confidence interval (CI)=1.1-1.39) of hospital admission for mental disorders, with a peak in these cases in June (RR=1.46, CI=1.19-1.7). Compared to other demographic groups, males and the elderly (aged over 60 years) were more sensitive to seasonal risk changes. In the summer season, the RR of hospital visits among men increased by 26% (RR=1.26, CI=1.12-1.41) and among the elderly by 23% (RR=1.23, CI=1.03-1.48). Furthermore, when temperatures including minimum, mean, and maximum increased 1°C, the number of cases for mental disorders increased by 1.7%, 2%, and 2.1%, respectively. CONCLUSION The study results showed a correlation between hospital admission for mental disorders and season.
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Affiliation(s)
- Phan Minh Trang
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden;
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Kim Bao Giang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Maria Nilsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Dominiak M, Swiecicki L, Rybakowski J. Psychiatric hospitalizations for affective disorders in Warsaw, Poland: Effect of season and intensity of sunlight. Psychiatry Res 2015; 229:287-94. [PMID: 26189339 DOI: 10.1016/j.psychres.2015.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 07/03/2015] [Accepted: 07/04/2015] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to assess any associations between the number of hospitalizations for affective disorders, seasons of the year and the intensity of sunlight in Poland, a country with a very changeable climate and significant seasonal fluctuations. We analyzed 2837 admissions with affective disorders hospitalized in the Institute of Psychiatry and Neurology in Warsaw, between 2002 and 2010 (mania, n=380, mixed episode, n=131, bipolar depression, n=736, recurrent depression, n=681, single depressive episode, n=909). For each diagnostic group admission time series were created and categorized into subgroups according to sex and age, and these were analyzed by means of the Autoregressive Integrated Moving Average (ARIMA) method. Regression models and correlations were used to assess the influence of the intensity of sunlight on the number of hospitalizations. Most mania admissions were noted in spring/summer months and in midwinter, mixed episode-late spring and winter, and depression (bipolar, recurrent and single depressive episode)-spring and autumn months. The association between frequency of admissions and monthly hours of sunshine was observed in some age and sex subgroups of patients with bipolar disorder and single depressive episode. The results support the seasonality of admissions of patients with affective disorders.
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Affiliation(s)
- Monika Dominiak
- Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland.
| | - Lukasz Swiecicki
- Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland
| | - Janusz Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, ul. Szpitalna 27/33, 60-572 Poznan, Poland
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Byrne EM, Raheja U, Stephens SH, Heath AC, Madden PAF, Vaswani D, Nijjar GV, Ryan KA, Youssufi H, Gehrman PR, Shuldiner AR, Martin NG, Montgomery GW, Wray NR, Nelson EC, Mitchell BD, Postolache TT. Seasonality shows evidence for polygenic architecture and genetic correlation with schizophrenia and bipolar disorder. J Clin Psychiatry 2015; 76:128-34. [PMID: 25562672 PMCID: PMC4527536 DOI: 10.4088/jcp.14m08981] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 08/29/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To test common genetic variants for association with seasonality (seasonal changes in mood and behavior) and to investigate whether there are shared genetic risk factors between psychiatric disorders and seasonality. METHOD Genome-wide association studies (GWASs) were conducted in Australian (between 1988 and 1990 and between 2010 and 2013) and Amish (between May 2010 and December 2011) samples in whom the Seasonal Pattern Assessment Questionnaire (SPAQ) had been administered, and the results were meta-analyzed in a total sample of 4,156 individuals. Genetic risk scores based on results from prior large GWAS studies of bipolar disorder, major depressive disorder (MDD), and schizophrenia were calculated to test for overlap in risk between psychiatric disorders and seasonality. RESULTS The most significant association was with rs11825064 (P = 1.7 × 10⁻⁶, β = 0.64, standard error = 0.13), an intergenic single nucleotide polymorphism (SNP) found on chromosome 11. The evidence for overlap in risk factors was strongest for schizophrenia and seasonality, with the schizophrenia genetic profile scores explaining 3% of the variance in log-transformed global seasonality scores. Bipolar disorder genetic profile scores were also associated with seasonality, although at much weaker levels (minimum P value = 3.4 × 10⁻³), and no evidence for overlap in risk was detected between MDD and seasonality. CONCLUSIONS Common SNPs of large effect most likely do not exist for seasonality in the populations examined. As expected, there were overlapping genetic risk factors for bipolar disorder (but not MDD) with seasonality. Unexpectedly, the risk for schizophrenia and seasonality had the largest overlap, an unprecedented finding that requires replication in other populations and has potential clinical implications considering overlapping cognitive deficits in seasonal affective disorders and schizophrenia.
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Affiliation(s)
- Enda M Byrne
- The University of Queensland, Queensland Brain Institute, Upland Rd, St Lucia, QLD 4072, Brisbane, Australia
| | - Uttam Raheja
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Sarah H. Stephens
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University, St.Louis, MO, USA
| | - Pamela AF Madden
- Department of Psychiatry, Washington University, St.Louis, MO, USA
| | | | - Dipika Vaswani
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Gagan V. Nijjar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA,Department of Psychiatry, Kaiser Permanente, Santa Rosa CA
| | - Kathleen A. Ryan
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hassaan Youssufi
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Philip R Gehrman
- Behavioral Sleep Medicine Program, Department of Psychiatry & Penn Sleep Center, University of Pennsylvania, Philadelphia, USA
| | - Alan R Shuldiner
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA,Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD, USA
| | - Nicholas G Martin
- Queensland Institute of Medical Research, 300 Herston Road, Herston, QLD 4029
| | - Grant W Montgomery
- Queensland Institute of Medical Research, 300 Herston Road, Herston, QLD 4029
| | - Naomi R Wray
- The University of Queensland, Queensland Brain Institute, St. Lucia, QLD 4072, Australia
| | - Elliot C Nelson
- Department of Psychiatry, Washington University, St.Louis, MO, USA
| | - Braxton D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA,Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA,Division of Child and Adolescent Psychiatry & University of Maryland Child and Adolescent Mental Health Innovations Center, University of Maryland School of Medicine, Baltimore, MD, USA,National Center for the Treatment of Phobias, Anxiety and Depression, Washington, DC, USA
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Resiliency to social defeat stress relates to the inter-strain social interaction and is influenced by season variation. Neurosci Lett 2014; 561:13-7. [DOI: 10.1016/j.neulet.2013.12.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 12/20/2013] [Indexed: 01/25/2023]
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Wang X, Lavigne E, Ouellette-kuntz H, Chen BE. Acute impacts of extreme temperature exposure on emergency room admissions related to mental and behavior disorders in Toronto, Canada. J Affect Disord 2014; 155:154-61. [PMID: 24332428 DOI: 10.1016/j.jad.2013.10.042] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to assess the effects of extreme ambient temperature on hospital emergency room visits (ER) related to mental and behavioral illnesses in Toronto, Canada. METHODS A time series study was conducted using health and climatic data from 2002 to 2010 in Toronto, Canada. Relative risks (RRs) for increases in emergency room (ER) visits were estimated for specific mental and behavioral diseases (MBD) after exposure to hot and cold temperatures while using the 50th percentile of the daily mean temperature as reference. Poisson regression models using a distributed lag non-linear model (DLNM) were used. We adjusted for the effects of seasonality, humidity, day-of-the-week and outdoor air pollutants. RESULTS We found a strong association between MBD ER visits and mean daily temperature at 28°C. The association was strongest within a period of 0-4 days for exposure to hot temperatures. A 29% (RR=1.29, 95% CI 1.09-1.53) increase in MBD ER vists was observed over a cumulative period of 7 days after exposure to high ambient temperature (99th percentile vs. 50th percentile). Similar associations were reported for schizophrenia, mood, and neurotic disorers. No significant associations with cold temperatures were reported. LIMITATIONS The ecological nature and the fact that only one city was investigated. CONCLUSIONS Our findings suggest that extreme temperature poses a risk to the health and wellbeing for individuals with mental and behavior illnesses. Patient management and education may need to be improved as extreme temperatures may become more prevalent with climate change.
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Affiliation(s)
- Xiang Wang
- Public Health Agency of Canada, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Environmental Issues Division, Canada; Faculty of Medicine, Department of Community Health and Epidemiology, Queen's University, Canada.
| | - Eric Lavigne
- Public Health Agency of Canada, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Environmental Issues Division, Canada.
| | - Hélène Ouellette-kuntz
- Faculty of Medicine, Department of Community Health and Epidemiology, Queen's University, Canada; Department of Psychiatry, Queen's University, Canada.
| | - Bingshu E Chen
- Faculty of Medicine, Department of Community Health and Epidemiology, Queen's University, Canada.
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De Jong S, Neeleman M, Luykx JJ, ten Berg MJ, Strengman E, Den Breeijen HH, Stijvers LC, Buizer-Voskamp JE, Bakker SC, Kahn RS, Horvath S, Van Solinge WW, Ophoff RA. Seasonal changes in gene expression represent cell-type composition in whole blood. Hum Mol Genet 2014; 23:2721-8. [PMID: 24399446 DOI: 10.1093/hmg/ddt665] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Seasonal patterns in behavior and biological parameters are widespread. Here, we examined seasonal changes in whole blood gene expression profiles of 233 healthy subjects. Using weighted gene co-expression network analysis, we identified three co-expression modules showing circannual patterns. Enrichment analysis suggested that this signal stems primarily from red blood cells and blood platelets. Indeed, a large clinical database with 51 142 observations of blood cell counts over 3 years confirmed a corresponding seasonal pattern of counts of red blood cells, reticulocytes and platelets. We found no direct evidence that these changes are linked to genes known to be key players in regulating immune function or circadian rhythm. It is likely, however, that these seasonal changes in cell counts and gene expression profiles in whole blood represent biological and clinical relevant phenomena. Moreover, our findings highlight possible confounding factors relevant to the study of gene expression profiles in subjects collected at geographical locations with disparaging seasonality patterns.
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Affiliation(s)
- Simone De Jong
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
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Licanin I, Fisekovic S, Babić S. Admission rate of patients with most common psychiatric disorders in relation to seasons and climatic factors during 2010/2011. Mater Sociomed 2013; 24:94-9. [PMID: 23922518 PMCID: PMC3732328 DOI: 10.5455/msm.2012.24.94-99] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 05/15/2012] [Indexed: 11/04/2022] Open
Abstract
Introduction: Climate and its impact on human health and mental illness have been in the focus of the research since years in the field. Aim: The aim of the research is to study the admissions rate to the psychiatric clinic in correlation to seasons and climate. Material and method: The research was conducted in a Psychiatric clinic of the Clinical Center in Sarajevo. Randomly selected subjects (aged 5-89 years, 1316 males and 1039 females) N=2355, were interviewed by the Structural Clinical Interview (SCID) which generated DSM-IV. In this retrospective-prospective, clinicalepidemiological study subjects were divided into groups according to type of disorders. Correlation between the impact of seasons and the rate of admissions to a Psychiatric clinic was analyzed. Certain data were taken from Federal Hydrometeorological Institute in Sarajevo of the climatic situation for period of the study. Results and conclusions: Of the total number of subjects who were admitted to the clinic in the period of 2010/2011 the most common diagnoses were F10-F19, F20-F29, F30-F39, F40-F48, and the suicide attempts as the separate entity. It was found correlation between certain seasons and the effects of the certain weather parameters at an increased admission rate of subjects with the certain diseases.
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Affiliation(s)
- Ifeta Licanin
- Psychiatric Clinics, Clinical Center, University of Sarajevo, Bosnia and Herzegovina
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