Association between ambient temperature and emergency psychiatric consultations: A case-crossover study in a South American emergency setting (2021

Abstract

Background:

Although environmental factors have been studied for their impact on mental health, the link between ambient temperature and mental disorders remains insufficiently explored.

Aim:

This study aimed to explore the relationship between ambient temperature and the frequency of emergency psychiatric consultations at the sole university hospital in Paraguay from 2021 to 2023.

Methods:

This investigation adopted a quantitative, observational, cross-sectional design, using a case-crossover approach. Data collection entailed reviewing patient records and meteorological data, focusing on the daily mean temperatures and other meteorological variables. Statistical analysis was conducted using RStudio and SPSS, applying a distributed lag non-linear model (DLNM) for a seven-day lag period. Multinomial logistic regression was used to estimate odds ratios (ORs) for the likelihood of specific diagnoses resulting in emergency consultations in relation to temperature exposure.

Results:

The analysis covered 2,186 first-time emergency psychiatric consultations, with anxiety disorders being the most frequent diagnosis (24.3%), followed by depressive disorders (23.4%) and personality disorders (15.8%). Women accounted for 70.6% of all patients. The findings indicated that higher temperatures were associated with a greater frequency of consultations for certain disorders, including bipolar (OR up to 27.12 at Lag 1) and eating disorders (OR up to 100 at Lag 1). Conversely, a negative association was observed for schizophrenia, dissociative disorders, and trauma- and stressor-related disorders as temperature increased. Additionally, a linear relationship was found between lower relative humidity and increased number of consultations.

Conclusions:

The findings underscore the impact of ambient temperature on psychiatric emergency consultations, revealing that the frequency of consultations for different conditions varies with temperature. These insights could inform public health strategies to mitigate the effects of climatic variation on mental health. These findings suggest the need for targeted mental health interventions to address vulnerabilities during periods of climatic stress, particularly in resource-limited settings.

Keywords

Mental disorders temperature psychiatric emergency services bipolar disorder anxiety humidity climate change epidemiology public health Paraguay

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References

Aguglia

Serafini

Escelsior

Canepa

Amore

Maina

(2019). Maximum temperature and solar radiation as predictors of bipolar patient admission in an emergency psychiatric ward. International Journal of Environmental Research and Public Health, 16(7), Article 1140. https://doi.org/10.3390/ijerph16071140

Ambrosetti

Macheret

Folliet

Wullschleger

Amerio

Aguglia

Serafini

Prada

Kaiser

Bondolfi

Sarasin

Costanza

(2021). Impact of the COVID-19 Pandemic on psychiatric admissions to a large Swiss emergency department: An observational study. International Journal of Environmental Research and Public Health, 18(3), Article 1174. https://doi.org/10.3390/ijerph18031174

Auerbach

R. P.

Mortier

Bruffaerts

Alonso

Benjet

Cuijpers

Demyttenaere

Ebert

D. D.

Green

J. G.

Hasking

Murray

Nock

M. K.

Pinder-Amaker

Sampson

N. A.

Stein

D. J.

Vilagut

Zaslavsky

A. M.

Kessler

R. C.

, & WHO WMH-ICS Collaborators. (2018). WHO world mental health surveys international college student project: Prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623–638. https://doi.org/10.1037/abn0000362

Baglioni

Nanovska

Regen

Spiegelhalder

Feige

Nissen

Reynolds

C. F.

Riemann

(2016). Sleep and mental disorders: A meta-analysis of polysomnographic research. Psychological Bulletin, 142(9), 969–990. https://doi.org/10.1037/bul0000053

Berry

H. L.

Bowen

Kjellstrom

(2010). Climate change and mental health: A causal pathways framework. International Journal of Public Health, 55(2), 123–132. https://doi.org/10.1007/s00038-009-0112-0

Bodini

Bonetto

Antonio

Bonora

Polati

Ricci

Paolillo

Amaddeo

Lasalvia

(2023). Changes in emergency psychiatric consultations in time of COVID-19: A retrospective observational study in the Verona academic hospital over the two pandemic years 2020–2021. BMC Emergency Medicine, 23(1), Article 18. https://doi.org/10.1186/s12873-023-00788-9

Bundo

Preisig

Merikangas

Glaus

Vaucher

Waeber

Marques-Vidal

Strippoli

M.-P. F.

Müller

Franco

Vicedo-Cabrera

A. M.

(2023). How ambient temperature affects mood: An ecological momentary assessment study in Switzerland. Environmental Health, 22(1), Article 52. https://doi.org/10.1186/s12940-023-01003-9

Catapano

Luciano

Cipolla

D’Amico

Cirino

Della Corte

M. C.

Sampogna

Fiorillo

(2024). What is the relationship between exposure to environmental pollutants and severe mental disorders? A systematic review on shared biological pathways. Brain, Behavior, & Immunity – Health, 43, Article 100922. https://doi.org/10.1016/j.bbih.2024.100922

Chan

E. Y. Y.

Lam

H. C. Y.

S. H.

Goggins

W. B.

Liu

Chung

P. P. W.

(2018). 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, 15(4), Article 754. https://doi.org/10.3390/ijerph15040754

10.

Charlson

F. J.

Ali

Benmarhnia

Pearl

Massazza

Augustinavicius

Scott

J. G.

(2021). Climate change and mental health: A scoping review. International Journal of Environmental Research and Public Health, 18(9), Article 4486. https://doi.org/10.3390/ijerph18094486

11.

Charlson

F. J.

Baxter

A. J.

Cheng

H. G.

Shidhaye

Whiteford

H. A.

(2016). The burden of mental, neurological, and substance use disorders in China and India: A systematic analysis of community representative epidemiological studies. The Lancet, 388(10042), 376–389. https://doi.org/10.1016/S0140-6736(16)30590-6

12.

Chen

Yuan

(2024). Examining the non-linear association between ambient temperature and mental health of elderly adults in the community: Evidence from Guangzhou, China. BMC Public Health, 24(1), Article 2064. https://doi.org/10.1186/s12889-024-19511-9

13.

Corvetto

J. F.

Federspiel

Sewe

M. O.

Müller

Bunker

Sauerborn

(2023). Impact of heat on mental health emergency visits: A time series study from all public emergency centres, in Curitiba, Brazil. BMJ Open, 13(12), Article e079049. https://doi.org/10.1136/bmjopen-2023-079049

14.

Crespi

(2018). The pineal hypothesis for drug dependence. International Physiology Journal, 2(1), 3–8. https://doi.org/10.14302/issn.2578-8590.ipj-18-2524

15.

Dakić

(2020). Mental health burden and unmet needs for treatment: A call for justice. The British Journal of Psychiatry, 216(5), 241–242. https://doi.org/10.1192/bjp.2019.254

16.

Di Nicola

Mazza

Panaccione

Moccia

Giuseppin

Marano

Grandinetti

Camardese

De Berardis

Pompili

Janiri

. (2020). Sensitivity to climate and weather changes in euthymic bipolar subjects: Association with suicide attempts. Frontiers in Psychiatry, 11, Article 95. https://doi.org/10.3389/fpsyt.2020.00095

17.

Goodman

Roiff

Oakes

A. H.

Paris

(2011). Suicidal risk and management in borderline personality disorder. Current Psychiatry Reports, 14(1), 79–85. https://doi.org/10.1007/s11920-011-0249-4

18.

Zhang

Gao

Cheng

Pan

Song

Liu

Tang

Song

(2022). The impact of cold spells on schizophrenia admissions and the synergistic effect with the air quality index. Environmental Research, 212, Article 113243. https://doi.org/10.1016/j.envres.2022.113243

19.

Kanikowska

Roszak

Rutkowski

Sato

Sikorska

Orzechowska

Bręborowicz

Witowski

(2019). Seasonal differences in rhythmicity of salivary cortisol in healthy adults. Journal of Applied Physiology, 126(3), 764–770. https://doi.org/10.1152/japplphysiol.00972.2018

20.

(2023). Stigma and related factors among renal dialysis patients in China. Frontiers in Psychiatry, 14, Article 1175179. https://doi.org/10.3389/fpsyt.2023.1175179

21.

Liu

(2024). Orientin promotes antioxidant capacity, mitochondrial biogenesis, and fiber transformation in skeletal muscles through the AMPK pathway. Journal of Agricultural and Food Chemistry, 72(12), 6226–6235. https://doi.org/10.1021/acs.jafc.3c08039

22.

Lupis

S. B.

Sabik

N. J.

Wolf

J. M.

(2016). Role of shame and body esteem in cortisol stress responses. Journal of Behavioral Medicine, 39(2), 262–275. https://doi.org/10.1007/s10865-015-9695-5

23.

Mackenzie

C. S.

Gekoski

W. L.

Knox

V. J.

(2006). Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging & Mental Health, 10(6), 574–582. https://doi.org/10.1080/13607860600641200

24.

Mauriz

Caloca-Amber

Vázquez-Casares

A. M.

(2020). Effect of facial skin temperature on the perception of anxiety: A pilot study. Healthcare, 8(3), Article 206. https://doi.org/10.3390/healthcare8030206

25.

Min

Shi

Wang

Yao

Tian

Zhang

Liang

Duan

Sun

(2019). Effect of apparent temperature on daily emergency admissions for mental and behavioral disorders in Yancheng, China: A time-series study. Environmental Health, 18(1), Article 98. https://doi.org/10.1186/s12940-019-0543-x

26.

Mittal

P. K.

Mehta

Solanki

R. K.

Swami

M. K.

Meena

P. S.

(2014). A cross-sectional study of factors affecting seasonality in bipolar disorder. South African Journal of Psychiatry, 20(2), Article 2. https://doi.org/10.4102/sajpsychiatry.v20i2.491

27.

Moraes

C. Á.

Cambras

Diez-Noguera

Schimitt

Dantas

Levandovski

Hidalgo

M. P.

(2013). A new chronobiological approach to discriminate between acute and chronic depression using peripheral temperature, rest-activity, and light exposure parameters. BMC Psychiatry, 13(1), Article 77. https://doi.org/10.1186/1471-244X-13-77

28.

Nachtigall

Lenga

Jóźwiak

Thürmann

P. A.

Meier-Hellmann

Kuhlen

Brederlau

Bauer

T. T.

Tebbenjohanns

Schwegmann

Hauptmann

Dengler

(2020). Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: An observational study. Clinical Microbiology and Infection, 26(12), 1663–1669. https://doi.org/10.1016/j.cmi.2020.08.011

29.

Noelke

McGovern

Corsi

D. J.

Jimenez

M. P.

Stern

Wing

I. S.

Berkman

(2016). Increasing ambient temperature reduces emotional well-being. Environmental Research, 151, 124–129. https://doi.org/10.1016/j.envres.2016.06.045

30.

Pail

Huf

Pjrek

Winkler

Willeit

Praschak-Rieder

Kasper

(2011). Bright-light therapy in the treatment of mood disorders. Neuropsychobiology, 64(3), 152–162. https://doi.org/10.1159/000328950

31.

Pedersen

C. B.

Bybjerg-Grauholm

Pedersen

M. G.

Grove

Agerbo

Bækvad-Hansen

Poulsen

J. B.

Hansen

C. S.

McGrath

J. J.

Als

T. D.

Goldstein

J. I.

Neale

B. M.

Daly

M. J.

Hougaard

D. M.

Mors

Nordentoft

Børglum

A. D.

Werge

Mortensen

P. B.

(2018). The iPSYCH2012 case–cohort sample: New directions for unravelling genetic and environmental architectures of severe mental disorders. Molecular Psychiatry, 23(1), 6–14. https://doi.org/10.1038/mp.2017.196

32.

Peng

Wang

Kan

Chen

Wang

(2017). Effects of ambient temperature on daily hospital admissions for mental disorders in Shanghai, China: A time-series analysis. Science of the Total Environment, 590–591, 281–286. https://doi.org/10.1016/j.scitotenv.2017.02.237

33.

Sloan

D. M.

(2002). Does warm weather climate affect eating disorder pathology? International Journal of Eating Disorders, 32(2), 240–244. https://doi.org/10.1002/eat.10077

34.

Sri

Bhugra

Persaud

Tribe

Gnanapragasam

Castaldelli-Maia

J. M.

Torales

Ventriglio

(2023). Global mental health and climate change: A geo-psychiatry perspective. Asian Journal of Psychiatry, 84, Article 103562. https://doi.org/10.1016/j.ajp.2023.103562

35.

Steel

Marnane

Iranpour

Chey

Jackson

J. W.

Patel

Silove

(2014). The global prevalence of common mental disorders: A systematic review and meta-analysis 1980–2013. International Journal of Epidemiology, 43(2), 476–493. https://doi.org/10.1093/ije/dyu038

36.

Thompson

Betts

Jovev

Nyathi

McDougall

Chanen

A. M.

(2017). Sexuality and sexual health among female youth with borderline personality disorder pathology. Early Intervention in Psychiatry, 13(3), 502–508. https://doi.org/10.1111/eip.12510

37.

Thompson

Hornigold

Page

Waite

(2018). Associations between high ambient temperatures and heat waves with mental health outcomes: A systematic review. Public Health, 161, 171–191. https://doi.org/10.1016/j.puhe.2018.06.008

38.

Torales

Barrios

(2023). Diseño de investigaciones: Algoritmo de clasificación y características esenciales. Medicina Clínica y Social, 7(3), 210–235. https://doi.org/10.52379/mcs.v7i3.349

39.

Trang

P. M.

Rocklöv

Giang

K. B.

Kullgren

Nilsson

(2016). Heatwaves and hospital admissions for mental disorders in Northern Vietnam. PLoS One, 11(5), Article e0155609. https://doi.org/10.1371/journal.pone.0155609

40.

Ventriglio

Torales

Castaldelli-Maia

J. M.

De Berardis

Bhugra

(2021). Urbanization and emerging mental health issues. CNS Spectrums, 26(1), 43–50. https://doi.org/10.1017/S1092852920001236

41.

Waszkiewicz

(2023). The immunoseasonal theory of psychiatric disorders. Journal of Clinical Medicine, 12(14), Article 4615. https://doi.org/10.3390/jcm12144615

42.

Yang

(2024). Gut microbiota and neonatal acute kidney injury. American Journal of Perinatology, 41(14), 1887–1894. https://doi.org/10.1055/a-2259-0101

43.

Zhang

Guo

Hua

(2020). Effects of hemodialysis, peritoneal dialysis, and renal transplantation on the quality of life of patients with end-stage renal disease. Revista Da Associação Médica Brasileira, 66(9), 1229–1234. https://doi.org/10.1590/1806-9282.66.9.1229

Association between ambient temperature and emergency psychiatric consultations: A case-crossover study in a South American emergency setting (2021–2023)

Abstract

Background:

Aim:

Methods:

Results:

Conclusions:

Keywords

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References