School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Queensland, Australia.
School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Queensland, Australia.
Environ Res. 2021 Jun;197:111003. doi: 10.1016/j.envres.2021.111003. Epub 2021 Mar 11.
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.
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.
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.
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.
气候驱动因素对精神分裂症住院的即时和延迟影响的证据有限且不一致。本研究旨在评估气候因素与澳大利亚昆士兰州精神分裂症每日住院之间的关联。
从昆士兰州卫生署获取了 1996 年 1 月 1 日至 2015 年 12 月 31 日期间所有私立和公立医院的精神分裂症每日住院数据。使用广义线性模型（GLM）和分布式滞后非线性模型（DLNM）分析了气候因素与精神分裂症住院之间的关联，这些模型适用于不同的气候区域。
在昆士兰州东南部，只有每日平均温度对精神分裂症入院有即时的负向影响（RR 0.93，95%CI 0.90-0.98，p 值<0.001）。对于其他地区，温度对住院的不利影响并不显著，但相对湿度（北部：RR 1.01，95%CI 1.00-1.02，p=0.05）和气压（北部：RR 1.03，95%CI 1.00-1.05，p=0.04；西南：RR 1.01，95%CI 1.00-1.02，p=0.05）对住院有即时和正向影响。此外，气候因素对昆士兰州不同地区的精神分裂症入院有一定的延迟影响，即温度在 0-4 滞后天（东南部：RR 0.97，95%CI 0.94-0.98，p=0.05；西南部：RR 0.96，95%CI 0.94-0.98，p=0.01）、相对湿度在 0-7 滞后天（北部：RR 0.95，95%CI 0.92-0.98，p=0.01；中部：RR 1.02，95%CI 1.00-1.03，p=0.05）和降雨在 0-21 滞后天（北部：RR 1.03，95%CI 1.01-1.04，p=0.01）上有显著的延迟影响。荟萃分析显示，温度（0-15 天滞后：RR 0.95，95%CI 0.93-0.98，p 值<0.001）、相对湿度（0-7 天：RR 0.96，95%CI 0.92-0.99，p<0.001）、降雨（0-21 天滞后：RR 1.03，95%CI 1.01-1.04，p<0.001）和气压（0-7 天滞后：RR 1.02，95%CI 1.00-1.04，p<0.001）对昆士兰州精神分裂症住院的短期和延迟关联有显著影响。
这是澳大利亚乃至国际上对气候因素与精神分裂症每日入院之间的短期和延迟关联进行的最大规模研究，研究结果表明，气候在精神分裂症急性发作的突然恶化中起着重要作用。因此，可以采取预防措施，以减少精神分裂症在脆弱期因症状加重和住院治疗的严重程度。
