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

Journal article
Authors Hanne Krage Carlsen
A. Oudin
S. Steingrimsson
D. O. Astrom
British Journal Of Psychiatry V. P. Rney Pa
Published in Int J Environ Res Public Health
Volume 16
Issue 2
ISSN 1660-4601
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Language en
Keywords psychiatric disorders, mental illness, environmental epidemiology, climate, hospital admissions, mental-disorders, heat-wave, weather variables, mortality, susceptibility, climate, deaths, health, cold, Environmental Sciences & Ecology, Public, Environmental & Occupational, Health
Subject categories Psychiatry


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.

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