Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
PLoS One. 2021 Oct 12;16(10):e0258302. doi: 10.1371/journal.pone.0258302. eCollection 2021.
Psychiatric disorders constitute a major public health concern that are associated with substantial health and socioeconomic burden. Psychiatric patients may be more vulnerable to high temperatures, which under current climate change projections will most likely increase the burden of this public health concern.
This study investigated the short-term association between ambient temperature and mental health hospitalizations in Bern, Switzerland.
Daily hospitalizations for mental disorders between 1973 and 2017 were collected from the University Hospital of Psychiatry and Psychotherapy in Bern. Population-weighted daily mean ambient temperatures were derived for the catchment area of the hospital from 2.3-km gridded weather maps. Conditional quasi-Poisson regression with distributed lag linear models were applied to assess the association up to three days after the exposure. Stratified analyses were conducted by age, sex, and subdiagnosis, and by subperiods (1973-1989 and 1990-2017). Additional subanalyses were performed to assess whether larger risks were found during the warm season or were due to heatwaves.
The study included a total number of 88,996 hospitalizations. Overall, the hospitalization risk increased linearly by 4.0% (95% CI 2.0%, 7.0%) for every 10°C increase in mean daily temperature. No evidence of a nonlinear association or larger risks during the warm season or heatwaves was found. Similar estimates were found across for all sex and age categories, and larger risks were found for hospitalizations related to developmental disorders (29.0%; 95% CI 9.0%, 54.0%), schizophrenia (10.0%; 95% CI 4.0%, 15.0%), and for the later rather than the earlier period (5.0%; 95% CI 2.0%, 8.0% vs. 2.0%; 95% CI -3.0%, 8.0%).
Our findings suggest that increasing temperatures could negatively affect mental status in psychiatric patients. Specific public health policies are urgently needed to protect this vulnerable population from the effects of climate change.
精神疾病是一个主要的公共卫生关注点，与大量的健康和社会经济负担有关。在当前气候变化的预测下，精神病患者可能更容易受到高温的影响，这很可能会增加这一公共卫生关注点的负担。
本研究调查了瑞士伯尔尼的环境温度与精神卫生住院治疗之间的短期关联。
从伯尔尼大学精神病学和心理治疗医院收集了 1973 年至 2017 年期间的精神障碍每日住院数据。从医院的集水区获取了 2.3 公里格网天气图的加权人口每日平均环境温度。应用条件拟泊松回归和分布式滞后线性模型来评估暴露后三天内的关联。通过年龄、性别和亚诊断进行分层分析，并通过子时段（1973-1989 年和 1990-2017 年）进行分析。还进行了额外的亚分析，以评估在温暖季节是否发现更大的风险，或者是否由于热浪导致更大的风险。
这项研究共纳入了 88996 例住院病例。总体而言，平均每日温度每升高 10°C，住院风险就会线性增加 4.0%（95%CI：2.0%，7.0%）。没有发现非线性关联或在温暖季节或热浪期间风险更大的证据。在所有性别和年龄类别中都发现了类似的估计值，并且与发育障碍（29.0%；95%CI：9.0%，54.0%）、精神分裂症（10.0%；95%CI：4.0%，15.0%）相关的住院治疗以及较晚时期（5.0%；95%CI：2.0%，8.0%）而不是较早时期（2.0%；95%CI：-3.0%，8.0%）的风险更大。
我们的研究结果表明，气温升高可能会对精神病患者的精神状态产生负面影响。迫切需要制定具体的公共卫生政策，以保护这一弱势群体免受气候变化的影响。
