Tupinier Martin Frédéric, Boudreault Jérémie, Campagna Céline, Lavigne Éric, Gamache Philippe, Tandonnet Matthieu, Généreux Mélissa, Trottier Simon, Goupil-Sormany Isabelle
Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City (Quebec), Canada; Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
Environ Res. 2024 Apr 1;246:118225. doi: 10.1016/j.envres.2024.118225. Epub 2024 Jan 20.
Some studies have found hot temperatures to be associated with exacerbations of schizophrenia, namely psychoses. As climate changes faster in Northern countries, our understanding of the association between temperature and hospital admissions (HA) for psychosis needs to be deepened.
A cohort of adults diagnosed with schizophrenia (n = 30,649) was assembled using Quebec's Integrated Chronic Disease Surveillance System (QICDSS). The follow-up spanned summers from 2001 to 2019, using hospital data from the QICDSS and meteorological data from the National Aeronautics and Space Administration's (NASA) Daymet database. In four geographic regions of the province of Quebec, a conditional logistic regression was used for the case-crossover analysis of the relationship between mean temperatures (at lags up to 6 days) and HAs for psychosis using a distributed lag non-linear model (DLNM). The analyses were adjusted for relative humidity, stratified according to individual (age, sex, and comorbidities) and ecological (material and social deprivation index and exposure to green space) factors, and then pooled through a meta-regression.
The statistical analyses revealed a statistically significant increase in HAs three days (lag 3) after elevated mean temperatures corresponding to the 90th percentile relative to a minimum morbidity temperature (MMT) (OR 1.040; 95% CI 1.008-1.074), while the cumulative effect over six days was not statistically significant (OR 1.052; 95% IC 0.993-1.114). Stratified analyses revealed non statistically significant gradients of increasing HAs relative to increasing material deprivation and decreasing green space levels.
The statistical analyses conducted in this project showed the pattern of admissions for psychosis after hot days. This finding could be useful to better plan health services in a rapidly changing climate.
一些研究发现高温与精神分裂症的病情加重有关，即与精神病发作有关。由于北方国家气候变化更快，我们需要加深对温度与精神病住院率（HA）之间关联的理解。
1）在被诊断为精神分裂症的成年人中，测量夏季平均温度与精神病住院率之间的关系。2）确定个体和生态特征对这种关系的影响。
利用魁北克综合慢性病监测系统（QICDSS）组建了一组被诊断为精神分裂症的成年人队列（n = 30,649）。随访时间跨度为2001年至2019年的夏季，使用了QICDSS的医院数据和美国国家航空航天局（NASA）Daymet数据库的气象数据。在魁北克省的四个地理区域，采用条件逻辑回归，使用分布滞后非线性模型（DLNM）对平均温度（滞后6天）与精神病住院率之间的关系进行病例交叉分析。分析针对相对湿度进行了调整，根据个体因素（年龄、性别和合并症）和生态因素（物质和社会剥夺指数以及绿地接触情况）进行分层，然后通过元回归进行汇总。
统计分析显示，相对于最低发病温度（MMT），对应第90百分位数的平均温度升高三天后（滞后3天），住院率有统计学意义的显著增加（OR 1.040；95% CI 1.008 - 1.074），而六天的累积效应无统计学意义（OR 1.052；95% IC 0.993 - 1.114）。分层分析显示，相对于物质剥夺增加和绿地水平降低，住院率增加的梯度无统计学意义。
本项目进行的统计分析显示了炎热天气后精神病的住院模式。这一发现可能有助于在快速变化的气候中更好地规划卫生服务。
