Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil
Objectives Quantify the risk of mental health (MH)-related emergency department visits (EDVs) due to heat, in the city of Curitiba, Brazil.Design Daily time series analysis, using quasi-Poisson combined with distributed lag non-linear model on EDV for MH disorders, from 2017 to 2021.Setting All nine...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e079049.full |
| _version_ | 1797370225154326528 |
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| author | Thomas Müller Rainer Sauerborn Aditi Bunker Maquins Odhiambo Sewe Julia Feriato Corvetto Andrea Federspiel |
| author_facet | Thomas Müller Rainer Sauerborn Aditi Bunker Maquins Odhiambo Sewe Julia Feriato Corvetto Andrea Federspiel |
| author_sort | Thomas Müller |
| collection | DOAJ |
| description | Objectives Quantify the risk of mental health (MH)-related emergency department visits (EDVs) due to heat, in the city of Curitiba, Brazil.Design Daily time series analysis, using quasi-Poisson combined with distributed lag non-linear model on EDV for MH disorders, from 2017 to 2021.Setting All nine emergency centres from the public health system, in Curitiba.Participants 101 452 EDVs for MH disorders and suicide attempts over 5 years, from patients residing inside the territory of Curitiba.Main outcome measure Relative risk of EDV (RREDV) due to extreme mean temperature (24.5°C, 99th percentile) relative to the median (18.02°C), controlling for long-term trends, air pollution and humidity, and measuring effects delayed up to 10 days.Results Extreme heat was associated with higher single-lag EDV risk of RREDV 1.03(95% CI 1.01 to 1.05—single-lag 2), and cumulatively of RREDV 1.15 (95% CI 1.05 to 1.26—lag-cumulative 0–6). Strong risk was observed for patients with suicide attempts (RREDV 1.85, 95% CI 1.08 to 3.16) and neurotic disorders (RREDV 1.18, 95% CI 1.06 to 1.31). As to demographic subgroups, females (RREDV 1.20, 95% CI 1.08 to 1.34) and patients aged 18–64 (RREDV 1.18, 95% CI 1.07 to 1.30) were significantly endangered. Extreme heat resulted in lower risks of EDV for patients with organic disorders (RREDV 0.60, 95% CI 0.40 to 0.89), personality disorders (RREDV 0.48, 95% CI 0.26 to 0.91) and MH in general in the elderly ≥65 (RREDV 0.77, 95% CI 0.60 to 0.98). We found no significant RREDV among males and patients aged 0–17.Conclusion The risk of MH-related EDV due to heat is elevated for the entire study population, but very differentiated by subgroups. This opens avenue for adaptation policies in healthcare: such as monitoring populations at risk and establishing an early warning systems to prevent exacerbation of MH episodes and to reduce suicide attempts. Further studies are welcome, why the reported risk differences occur and what, if any, role healthcare seeking barriers might play. |
| first_indexed | 2024-03-08T17:59:14Z |
| format | Article |
| id | doaj.art-7296fce824ea47198406126529646e05 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-08T17:59:14Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-7296fce824ea47198406126529646e052024-01-02T03:05:08ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-079049Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, BrazilThomas Müller0Rainer Sauerborn1Aditi Bunker2Maquins Odhiambo Sewe3Julia Feriato Corvetto4Andrea Federspiel5Private Psychiatric Hospital, Meiringen, SwitzerlandHeidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany1 Network Aging Research, Heidelberg University, Heidelberg, Germany3 Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, SwedenHeidelberg Institute of Global Health, Universität Heidelberg, Heidelberg, GermanyPrivate Psychiatric Hospital, Meiringen, SwitzerlandObjectives Quantify the risk of mental health (MH)-related emergency department visits (EDVs) due to heat, in the city of Curitiba, Brazil.Design Daily time series analysis, using quasi-Poisson combined with distributed lag non-linear model on EDV for MH disorders, from 2017 to 2021.Setting All nine emergency centres from the public health system, in Curitiba.Participants 101 452 EDVs for MH disorders and suicide attempts over 5 years, from patients residing inside the territory of Curitiba.Main outcome measure Relative risk of EDV (RREDV) due to extreme mean temperature (24.5°C, 99th percentile) relative to the median (18.02°C), controlling for long-term trends, air pollution and humidity, and measuring effects delayed up to 10 days.Results Extreme heat was associated with higher single-lag EDV risk of RREDV 1.03(95% CI 1.01 to 1.05—single-lag 2), and cumulatively of RREDV 1.15 (95% CI 1.05 to 1.26—lag-cumulative 0–6). Strong risk was observed for patients with suicide attempts (RREDV 1.85, 95% CI 1.08 to 3.16) and neurotic disorders (RREDV 1.18, 95% CI 1.06 to 1.31). As to demographic subgroups, females (RREDV 1.20, 95% CI 1.08 to 1.34) and patients aged 18–64 (RREDV 1.18, 95% CI 1.07 to 1.30) were significantly endangered. Extreme heat resulted in lower risks of EDV for patients with organic disorders (RREDV 0.60, 95% CI 0.40 to 0.89), personality disorders (RREDV 0.48, 95% CI 0.26 to 0.91) and MH in general in the elderly ≥65 (RREDV 0.77, 95% CI 0.60 to 0.98). We found no significant RREDV among males and patients aged 0–17.Conclusion The risk of MH-related EDV due to heat is elevated for the entire study population, but very differentiated by subgroups. This opens avenue for adaptation policies in healthcare: such as monitoring populations at risk and establishing an early warning systems to prevent exacerbation of MH episodes and to reduce suicide attempts. Further studies are welcome, why the reported risk differences occur and what, if any, role healthcare seeking barriers might play.https://bmjopen.bmj.com/content/13/12/e079049.full |
| spellingShingle | Thomas Müller Rainer Sauerborn Aditi Bunker Maquins Odhiambo Sewe Julia Feriato Corvetto Andrea Federspiel Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil BMJ Open |
| title | Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil |
| title_full | Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil |
| title_fullStr | Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil |
| title_full_unstemmed | Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil |
| title_short | Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil |
| title_sort | impact of heat on mental health emergency visits a time series study from all public emergency centres in curitiba brazil |
| url | https://bmjopen.bmj.com/content/13/12/e079049.full |
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