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Tu L, Liu Y, Zhu H, Zhang Q, Ji X. Characteristics of drug overdose suicide attempts presenting to the psychiatric emergency department of Beijing Anding Hospital. BMC Public Health 2024; 24:1597. [PMID: 38877447 PMCID: PMC11179331 DOI: 10.1186/s12889-024-19095-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Overdose-related suicide attempts represent a significant portion of self-harm presentations in the psychiatric emergency department (ED). Identifying specific patient characteristics associated with these attempts holds promise for pinpointing drug classes with elevated risk and paving the way for tailored suicide prevention interventions. This study aims to examine the demographic profiles of ED patients who had experienced overdose-related suicide attempts. METHODS This retrospective study was conducted at Beijing Anding Hospital, Capital Medical University, from January 2020 to December 2021. Patients with psychiatric drug overdose suicide attempts presenting to the psychiatric ED were included. Sociodemographic characteristics and the specific classes of drugs involved were collected, and analysed descriptively. RESULTS This study examined 252 overdose patients, excluding 51 patients treated with alcohol or nonpsychiatric drugs, and a total 201 cases were included. The mean age of the patients was 28 ± 16 years (median 23, range 12-78), and 82% (n = 165) of the sample were females. Notably, nearly half (45%) of the patients were aged ≤ 20 years. While the number of cases decreased with increasing age, a significant increase was observed in 2021 compared to 2020. Benzodiazepines (BZDs) were the most frequently implicated substance class (n = 126, 63%), followed by antidepressants (n = 96, 48%), antipsychotics (n = 44, 22%), Z-drugs (n = 43, 21%), and mood stabilizers (n = 36, 18%). For adolescents, antidepressants (n = 52, 71%) overtook BZDs (n = 38, 52%) as the most common drug. The monthly distribution of cases revealed peaks in April and November. Furthermore, 21% (n = 42) of patients ingested more than two psychotropic medications concurrently. Finally, approximately half (n = 92) of the patients required inpatient admission for further treatment. Comparisons between hospitalized and nonhospitalized patients did not reveal any significant differences. CONCLUSIONS The present study revealed a greater prevalence of suicide overdose attempts among young females receiving prescriptions for antidepressants and/or BZDs. This finding suggests a potential need for enhanced monitoring of suicidal behaviour in this specific population when prescribing psychotropic medications. These findings contribute to the growing body of knowledge regarding drug overdose suicide attempts in psychiatric emergency settings and underscore the importance of further research to develop targeted prevention interventions.
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Affiliation(s)
- Lihui Tu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, & the Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
| | - Yi Liu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, & the Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
| | - Hui Zhu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, & the Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, & the Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
| | - Xiao Ji
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, & the Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
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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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Virtanen M, Törmälehto S, Partonen T, Elovainio M, Ruuhela R, Hakulinen C, Komulainen K, Airaksinen J, Väänänen A, Koskinen A, Sund R. Seasonal patterns of sickness absence due to diagnosed mental disorders: a nationwide 12-year register linkage study. Epidemiol Psychiatr Sci 2023; 32:e64. [PMID: 37941381 PMCID: PMC7615330 DOI: 10.1017/s2045796023000768] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
AIMS Although seasonality has been documented for mental disorders, it is unknown whether similar patterns can be observed in employee sickness absence from work due to a wide range of mental disorders with different severity level, and to what extent the rate of change in light exposure plays a role. To address these limitations, we used daily based sickness absence records to examine seasonal patterns in employee sickness absence due to mental disorders. METHODS We used nationwide diagnosis-specific psychiatric sickness absence claims data from 2006 to 2017 for adult individuals aged 16-67 (n = 636,543 sickness absence episodes) in Finland, a high-latitude country with a profound variation in daylength. The smoothed time-series of the ratio of observed and expected (O/E) daily counts of episodes were estimated, adjusted for variation in all-cause sickness absence rates during the year. RESULTS Unipolar depressive disorders peaked in October-November and dipped in July, with similar associations in all forms of depression. Also, anxiety and non-organic sleep disorders peaked in October-November. Anxiety disorders dipped in January-February and in July-August, while non-organic sleep disorders dipped in April-August. Manic episodes reached a peak from March to July and dipped in September-November and in January-February. Seasonality was not dependent on the severity of the depressive disorder. CONCLUSIONS These results suggest a seasonal variation in sickness absence due to common mental disorders and bipolar disorder, with high peaks in depressive, anxiety and sleep disorders towards the end of the year and a peak in manic episodes starting in spring. Rapid changes in light exposure may contribute to sickness absence due to bipolar disorder. The findings can help clinicians and workplaces prepare for seasonal variations in healthcare needs.
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Affiliation(s)
- M. Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - S. Törmälehto
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - T. Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - M. Elovainio
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R. Ruuhela
- Weather and Climate Change Impact Research, Finnish Meteorological Institute, Helsinki, Finland
| | - C. Hakulinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - K. Komulainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - J. Airaksinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A. Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A. Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - R. Sund
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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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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Liu L, Wu Q, Li X, Song R, Wei N, Liu J, Yuan J, Yan S, Sun X, Liang Y, Li Y, Jin X, Wu Y, Mei L, Song J, Yi W, Pan R, Cheng J, Su H. Sunshine duration and risks of schizophrenia hospitalizations in main urban area: Do built environments modify the association? THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:162057. [PMID: 36758693 DOI: 10.1016/j.scitotenv.2023.162057] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Although studies have explored the relationship between sunshine duration and schizophrenia, the evidence was ambiguous. Different built environments may alter the effect of sunlight on schizophrenia, thus the purpose of this study was to investigate the effects of built environments on the sunshine duration-schizophrenia association. MATERIALS AND METHODS Daily schizophrenia hospitalizations data during 2017-2020 in Hefei's main urban area, China, and corresponding meteorological factors as well as ambient pollutants were collected. The impact of sunshine duration on schizophrenia admissions in urban areas was investigated using a generalized additive model combined with a distributed lagged nonlinear model. Additionally, the various modifying effects of different Building Density, Building Height, Normalized Vegetation Index, and Nighttime Light were also explored between sunshine duration and schizophrenia. RESULTS We observed that inadequate sunshine duration (<5.3 h) was associated with an increase in schizophrenia hospital admissions, with a maximum relative risk of 1.382 (95 % confidence interval (CI): 1.069-1.786) at 2.9 h. In turn, adequate sunshine duration reduced the risk of schizophrenia hospitalizations. Subgroup analyses indicated females and old patients were particularly vulnerable. In the case of insufficient sunshine duration, significant positive effects were noticed on schizophrenia risk at High-Building Density and High-Nighttime Light. Higher NDVI as well as Building Height were found to be associated with lower risks of schizophrenia. CONCLUSIONS Given that sunshine duration in various built environments might lead to distinct effects on schizophrenia hospitalizations. Our findings assist in identifying vulnerable populations that reside in particular areas, thus suggesting policymakers provide advice to mitigate the onset of schizophrenia by allocating healthcare resources rationally and avoiding adverse exposures to vulnerable populations timely.
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Affiliation(s)
- Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Qing Wu
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China.
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Törmälehto S, Svirskis T, Partonen T, Isometsä E, Pirkola S, Virtanen M, Sund R. Seasonal Effects on Hospitalizations Due to Mood and Psychotic Disorders: A Nationwide 31-Year Register Study. Clin Epidemiol 2022; 14:1177-1191. [PMID: 36304786 PMCID: PMC9595069 DOI: 10.2147/clep.s372341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/30/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine seasonal patterns of hospital admissions due to mood and psychotic disorders and to investigate whether the admission rates show variation according to the seasonal daylength (photoperiods). Patients and Methods A retrospective nationwide register-based cohort of all psychiatric admissions (N=978,079) during 1987–2017 in Finland was utilized. The smoothed time-series of adjusted ratio of observed and expected (O/E) daily counts were estimated to examine seasonal variation. The mean O/E with 95% confidence intervals (CI) was used to study the admission rates by photoperiods. The calendar days were classified into the 71-day photoperiods based on the daylength (long/summer, short/winter, equal/spring, equal/fall) and the pace of change in daylength (slowly/rapidly increasing/decreasing daylength). Results Manic episodes peaked in summer during the long (mean O/E=1.10, 95% CI=1.06–1.13) and slowly decreasing (1.09, 1.06–1.13) photoperiods and had a nadir in winter during the slowly increasing (0.93, 0.89–0.98) photoperiod. Admissions for unipolar depressive (UPD) episodes peaked in autumn and in spring at the end of the rapidly decreasing (1.03, 1.02–1.04) and increasing (1.03, 1.01–1.04) photoperiod, and dropped in summer during the long and slowly decreasing (0.95, 0.94–0.96) photoperiods. Bipolar depressive (BPD) and mixed episodes signaled excess admissions in autumn and in spring. Admissions for schizophrenia were higher than expected from summer to early-autumn, during the long and slowly decreasing photoperiods (1.02, 1.02–1.03), and lower than expected in other seasons, especially in mid-spring during the rapidly increasing photoperiod (0.98, 0.98–0.99). Conclusion The study indicates the seasonality and photoperiodicity of mental disorders, especially for manic episodes. The seasonal pattern is similar between schizophrenia and manic episodes, and between UPD, BPD, and mixed episodes.
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Affiliation(s)
- Soili Törmälehto
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland,Correspondence: Soili Törmälehto, School of Educational Sciences and Psychology C/O Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio, FI-70211, Finland, Email
| | - Tanja Svirskis
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sami Pirkola
- Faculty of Social Sciences, University of Tampere and Pirkanmaa Hospital District, Tampere, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Reijo Sund
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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Dionisie V, Ciobanu AM, Moisa E, Manea MC, Puiu MG. The Impact of the COVID-19 Pandemic on Inpatient Admissions for Psychotic and Affective Disorders: The Experience of a Large Psychiatric Teaching Hospital in Romania. Healthcare (Basel) 2022; 10:healthcare10081570. [PMID: 36011227 PMCID: PMC9407826 DOI: 10.3390/healthcare10081570] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic resulted in a global sanitary crisis and, in addition, elicited serious mental health consequences. The utilization of psychiatric hospital-based services acts as an indicator of public mental health. Therefore, this research sought to investigate differences in the numbers and characteristics of inpatient admissions for psychotic and affective disorders at the largest Romanian psychiatric hospital between the period of lockdown (16 March−15 May 2020) and another three corresponding periods: the same year in the pre-lockdown period (16 January−15 March 2020), the immediate post-lockdown period (16 May−15 July 2020), and two years later (16 March−15 May 2022). A retrospective analysis was performed. The study included a total of 6604 patients. Inpatient admissions decreased during lockdown in comparison with the pre-lockdown period and immediate post-lockdown period for psychotic disorders (p < 0.001 and p < 0.001, respectively) and affective disorders (p < 0.001 and p < 0.001, respectively). For both psychotic and affective disorders, a decrease in the age of the patients admitted during lockdown, as compared with the pre-lockdown period (p < 0.05 and p < 0.001, respectively), was observed. The length of the hospital stay for affective disorders was higher immediately post-lockdown in comparison with the lockdown period (p < 0.001). Collectively, the present findings provide a glimpse of the immediate and long-term consequences of the COVID-19 pandemic and lockdown measures on patients’ access to mental healthcare in the form of hospitalization, and these findings could provide the basis for the development of a different approach to times of crisis.
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Affiliation(s)
- Vlad Dionisie
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Discipline of Psychiatry, Neurosciences Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Emanuel Moisa
- Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Correspondence: (M.C.M.); (M.G.P.)
| | - Maria Gabriela Puiu
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Correspondence: (M.C.M.); (M.G.P.)
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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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Nejati N, Crocker C, Kolajova M, Morrison J, Simon P, Sridharan S, Tibbo P. Examination of the impact of COVID-19 public health quarantine measures on acute mental health care services: A retrospective observational study. Psychiatry Res 2021; 302:113999. [PMID: 34038806 PMCID: PMC8117541 DOI: 10.1016/j.psychres.2021.113999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/09/2021] [Indexed: 02/07/2023]
Abstract
This study assesses for the impact of Covid-19 public health quarantine measures on acute care psychiatric admissions, by comparing admission data from the quarantine period to a comparator period. A chart review was conducted for all admissions to an urban acute care psychiatric centre from Mar 22 - June 5 2020 (quarantine) and January 5 - Mar 21 2020 (comparator). Data was collected on the number of admissions, demographics, patients' psychiatric history, characteristics of admissions, discharge information, patients' substance use and social factors. Data was analyzed using a student's t-test for continuous variables and Chi squared analyses for categorical variables. Results demonstrated 185 admissions during quarantine and 190 during the comparator, with no significant differences in the distribution of admissions across time periods. There was a significantly greater frequency of admissions in the 35-44 age bracket and admissions involving substance use during quarantine. Additionally, admissions during quarantine were significantly shorter, with increased frequency of involuntary status and use of seclusion. The data suggests a vulnerability specific to individuals in their 30-40s during quarantine and demonstrates a need to better understand factors impacting this group. It also suggests that quarantine is associated with changes to substance use, potentiating high acuity illness requiring admission.
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Affiliation(s)
- Nadine Nejati
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Mental Health and Addictions, Nova Scotia Health, Nova Scotia, Canada.
| | - Candice Crocker
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Miroslava Kolajova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Mental Health and Addictions, Nova Scotia Health, Nova Scotia, Canada
| | - Jason Morrison
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Mental Health and Addictions, Nova Scotia Health, Nova Scotia, Canada
| | - Patryk Simon
- Department of Mental Health and Addictions, Nova Scotia Health, Nova Scotia, Canada
| | - Sanjana Sridharan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Mental Health and Addictions, Nova Scotia Health, Nova Scotia, Canada
| | - Philip Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Mental Health and Addictions, Nova Scotia Health, Nova Scotia, Canada
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Höschl C. Introduction: An overview of NIMH (Klecany, CZ) scientific activities. Neurosci Lett 2021; 749:135790. [PMID: 33652089 DOI: 10.1016/j.neulet.2021.135790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/24/2021] [Indexed: 11/29/2022]
Abstract
An overview of research activities of National Institute of Mental Health (NIMH) in Klecany, Czech republic. The institute was funded by EU operational project Research and Development for Innovation and started working in 2015. NIMH activities are organized in eight research programs including the neurobiology of the serious mental disorders, social psychiatry, brain imaging and use of information technologies in psychiatric research, epidemiology of addictions, sleep laboratory and chronobiology, electrophysiology, clinical research, and transfer of technologies. The equipment and expertise ranks NIMH Klecany among top neuroscience research institutions in central and eastern Europe.
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Fico G, de Toffol M, Anmella G, Sagué-Vilavella M, Dellink A, Verdolini N, Pacchiarotti I, Goikolea JM, Solmi M, Vieta E, Murru A. Clinical correlates of seasonality in bipolar disorder: A specifier that needs specification? Acta Psychiatr Scand 2021; 143:162-171. [PMID: 33140436 DOI: 10.1111/acps.13251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/09/2020] [Accepted: 10/28/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Seasonal pattern (SP) is a bipolar disorder (BD) specifier that indicates a tendency towards affective relapses during specific moments of the year. SP affects 15%-25% of BD patients. In the past, SP was applied only to depressive relapses while, in DSM-5, SP may be applied to both depressive and (hypo)manic episodes. We examined the association between different clinical correlates of BD and SP according to its current definition in a cohort of patients with BD type I (BDI) and II (BDII). METHODS Patients were recruited from a specialized unit and assessed according to the season of relapse and type of episode per season. SP and non-SP patients were compared looking into sociodemographic and clinical correlates. Significant variables at univariate comparisons were included in multivariate logistic regression with SP as the dependent variable. RESULTS 708 patients were enrolled (503 BDI, 205 BDII), and 117 (16.5%) fulfilled DSM-5 criteria for SP. The mean age was 45.3 years (SD = 14.18), and 389 were female (54.9%). The logistic regression model included a significant contribution of BDII (OR = 2.23, CI 1.4-3.55), family history of mood disorder (OR = 1.97, CI 1.29-3.01), undetermined predominant polarity (OR = 0.44, CI 0.28-0.70), and aggressive behavior (OR = 0.42, CI 0.23-0.75). CONCLUSION Our results outline a novel positive association of SP with undetermined predominant polarity, BDII, family history of mood disorder, and with fewer aggressiveness-related symptoms. Seasonality is associated with a biphasic pattern with similar dominance of (hypo)mania and depression and is more frequent in BDII as compared to BDI. Seasonal episodes may be easier to predict, but difficult to prevent.
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Affiliation(s)
- Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Marco de Toffol
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.,Neurosciences Department, University of Padua, Padua, Italy
| | - Gerard Anmella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Maria Sagué-Vilavella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Annelies Dellink
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.,Behavioural and Cognitive Neuroscience Programme, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Jose Manuel Goikolea
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Marco Solmi
- Neurosciences Department, University of Padua, Padua, Italy
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Andrea Murru
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
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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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