School of Psychiatry, UNSW, Sydney, NSW, Australia; Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia.
School of Psychiatry, UNSW, Sydney, NSW, Australia; Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia.
J Affect Disord. 2018 Jan 15;226:72-76. doi: 10.1016/j.jad.2017.09.014. Epub 2017 Sep 21.
Causes for a seasonal impact on admissions for mania remain to be clarified. We examined the impact of photoperiod, rate of change of photoperiod and hours of sunshine on admissions over an extended period.
Monthly admission data to NSW psychiatric hospitals for more than twenty thousand patients admitted for mania over a fifteen-year period were correlated with photoperiod and sunshine changes.
While the peak in admissions occurred in spring, the shift in admissions being under-represented to being precipitously over-represented corresponded with the photoperiod commencing to increase in winter (i.e. July). Analyses identified rate of change in photoperiod as somewhat more influential than change in photoperiod and with hours of sunshine not making a distinctive contribution. Immediate and delayed impacts of rate of change as well as change in photoperiod across the whole year accounted for a distinctive 20% of the variance in hospital admissions.
Validity of mania diagnoses cannot be established from the data set, admission data were obtained from across the state while meteorological data were obtained from the capital city, lag periods between onset of a mania and hospitalization (while identified) would impact on associations, social factors were not included and study associations do not imply causality.
The lack of a strong year-long correlation may reflect photoperiod changes being only a weak causal factor or that its influence may be through a strong impact phase after the winter solstice and with the spring peaking of admissions reflecting secondary photoperiod or other influences.
躁狂症入院人数的季节性影响因素仍需阐明。我们考察了光周期、光周期变化率和日照时间对延长时间段内躁狂症入院人数的影响。
将十五年间新南威尔士州精神病医院两万多名躁狂症入院患者的每月入院数据与光周期和日照变化相关联。
尽管入院高峰期出现在春季，但入院人数的转变是从代表性不足到急剧增加，这与冬季（即 7 月）光周期开始增加相吻合。分析表明，光周期变化率的影响比光周期变化稍大，日照时间没有明显贡献。光周期变化率的即时和延迟影响以及全年的光周期变化解释了医院入院人数的 20%的显著差异。
无法从数据集确定躁狂症诊断的有效性，入院数据是从全州获得的，而气象数据是从首府城市获得的，躁狂症发作和住院之间的时间滞后（虽然已确定）会影响关联，社会因素未包括在内，且研究关联并不意味着因果关系。
缺乏全年的强相关性可能反映出光周期变化只是一个较弱的因果因素，或者其影响可能是在冬至后的强烈影响阶段之后，而春季入院人数的峰值反映了次要光周期或其他影响。
