Ambient Temperature and Associations with Daily Visits to a Psychiatric Emergency Unit in Sweden

Abstract

High or low ambient temperatures pose a risk factor for the worsening or onset of psychiatric disorders. The aim of this study was to investigate the association between ambient temperature and psychiatric emergency visits in an urban region in a temperate climate. The daily number of visits to a psychiatric emergency room (PEVs) at Sahlgrenska University Hospital, Gothenburg, Sweden and the daily mean temperature were extracted for the study period 1 July 2012 to 31 December 2017. Case-crossover analysis with distributed lag non-linear models was used to analyse the data by season. The warm season was defined as May to August and the cold season as November to February. Shorter lags periods were used for the warm season than the cold season. In the analysis, temperatures at the 95th percentile was associated with 14% (95% confidence interval (CI): 2%, 28%) increase in PEVs at lag 0–3 and 22% (95%CI: 6%, 40%) for lags 0–14 during the warm season, relative to the seasonal minimum effect temperature (MET). During the cold season temperatures at the 5th percentile were associated with 25% (95% CI: −8%, 13%) and 18% (95% CI: −30%, 98%) increase in PEVs at lags 0–14 and 0–21 respectively. We observed an increased number of PEVs at high and low temperatures; however, not to a statistically significant extent for low temperatures. Our findings are similar to what has been found for somatic diseases and in studies of other mental health outcomes in regions with more extreme climates. This merits the inclusion of individuals with psychiatric disorders in awareness planning for climate warning systems.

Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: A time-series study

“…In addition, the study in Germany identified high risk of hospital admissions due to MDs at lower temperatures ( Shiue et al, 2016 ). When compared the effects of low and high AT in our study, we found a much stronger effect of high AT on MDs, which has also been demonstrated in most of the related studies that a close correlation between high temperature and MDs existed ( Peng et al, 2017 ; Carlsen et al, 2019 ; Almendra et al, 2019 ; Min et al, 2019 ). We suggested that the difference of effects between low and high temperature needed to be further studied in the future.…”

“…In our study, the single day effect of low AT emerged from the 3rd day to the 6th day and the maximum increased risk could be 4.3% on the 4th day after exposure. An increased number of psychiatric emergency room at high and low temperatures was also observed by Carlsen et al (2019) in Sweden. Low temperature was associated with the increase of 18%–25% in psychiatric emergency room but not to a statistically significant extent.…”

“… Brandl et al (2018) investigated the influence of weather conditions on the number of psychiatric emergency room patients and found that number of patients in the emergency room increased on warmer and on cloudy days, while lower patient numbers during very cold temperatures. However, Carlsen et al (2019) found daily number of visits to psychiatric emergency room increased by 22% and 25% when the temperatures were at the 95th percentile and the 5th percentile at lag 0–14 in Sweden, respectively, relative to the seasonal minimum effect temperature. Another study in Lisbon showed a significantly increased risk of hospital admissions of mental and behavioral disorders (MDs) with high temperatures at lag 0–1 and at lag 0–2 days ( Almendra et al, 2019 ).…”

Effect of apparent temperature on daily emergency admissions for mental and behavioral disorders in Yancheng, China: a time-series study

“…Another study found that both high and low ATs were associated with admissions for schizophrenia in Hefei, China [16]. In addition, several studies have examined the relationship between ambient mean temperature and MDs admissions in Toronto, Canada [9]; Shanghai, China [11]; and Sweden [18]. The higher AT effect observed in our study was consistent with the effect of high ambient mean temperature reported in previous studies but differed from the results by Basu et al [17].…”

Changes in Psychiatric Inpatient Service Utilization During the First and Second Waves of the COVID-19 Pandemic

“…The Sahlgrenska University Hospital serves an area of approximately one million adult inhabitants, which makes it one of the largest in Northern Europe ( 20 ). The Psychiatric Emergency Department is open 24 h daily all week and is available for all with or without referral.…”