Maximum Temperature and Solar Radiation as Predictors of Bipolar Patient Admission in an Emergency Psychiatric Ward

Aguglia, Andrea; Serafini, Gianluca; Escelsior, Andrea; Canepa, Giovanna; Amore, Mario; Maina, Giuseppe

doi:10.3390/ijerph16071140

Cited by 25 publications

(16 citation statements)

References 51 publications

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“…Studies of the association between hospital admissions of BD patients and solar radiation, maximum temperature, and seasonal patterns in photoperiod have shown that manic episodes tend to peak during spring and summer months, with a minor peak in autumn (Aguglia et al, 2017(Aguglia et al, , 2018(Aguglia et al, , 2019. In contrast, depressive episodes displayed peaks in early winter and less frequently in summer, with mixed episodes peaking in early spring or summer.…”

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confidence: 99%

“…Taken together, the compelling evidence in support of circadian disturbances in BD may also feed into seasonal influences relating to the onset of symptoms of bipolar mania or bipolar depression. Studies of the association between hospital admissions of BD patients and solar radiation, maximum temperature, and seasonal patterns in photoperiod have shown that manic episodes tend to peak during spring and summer months, with a minor peak in autumn (Aguglia et al., 2017 , 2018 , 2019 ). In contrast, depressive episodes displayed peaks in early winter and less frequently in summer, with mixed episodes peaking in early spring or summer.…”

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confidence: 99%

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Rate of change in solar insolation is a hidden variable that influences seasonal alterations in bipolar disorder

et al. 2021

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confidence: 99%

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Rate of change in solar insolation is a hidden variable that influences seasonal alterations in bipolar disorder

et al. 2021

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“…In Germany and Greece, increased solar insolation may precede suicidal acts (Müller et al 2011 ; Papadopoulos et al 2005 ). In Italy, higher solar radiation was associated with an increase in patients admitted to an emergency psychiatric unit with a primary diagnosis of bipolar disorder (Aguglia et al 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Bauer¹,

Glenn²,

Achtyes³

et al. 2021

Int J Bipolar Disord

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Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.

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“…Similarly, Sherbakov et al (2018) concluded admissions for mental health were significantly increased with higher temperatures in California, US. The study in Italy showed temperature and humidex index were significantly associated with admission in an emergency psychiatric ward, and maximum temperature and solar radiation were associated with bipolar disorder ( Aguglia et al, 2020 , Aguglia et al, 2019a ). Significantly increased risk of the admission counts for schizophrenia was observed at a temperature range of 3.2 °C (10th percentile), and 12.1 °C (99th percentile) in Taiwan, China ( Sung et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: A time-series study

Niu

Gao

Yang

et al. 2020

Science of The Total Environment

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Background The relationship between temperature and mental disorders is still unclear. This study aims to assess the short-term effect of apparent temperature (AT) on daily emergency visits of mental and behavioral disorders (MDs) in Beijing, China. Methods Daily counts of emergency visits related to MDs in Beijing from 2016 to 2018 were obtained. A quasi-Poisson generalized additive model combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between AT and emergency admissions related to MDs. Sunshine duration, precipitation, PM 2.5 , SO 2 , O 3 , time trend, day of week and holiday were adjusted in the model. Results Total daily emergency visits for MDs during the study period were 16,606. With the reference of −2.4 °C (temperature with the minimum emergency visit risk), the single day effects of low AT (−8.6 °C, 10th percentile) and high AT (9.2 °C, 90th percentile) on MDs emergency visits reached a relative risk peak of 1.043 (95%CI: 1.017–1.069) on lag day 4 and 1.105 (95%CI: 1.006–1.215) on lag day 1, respectively. The greatest cumulative effect of high AT emerged on lag 0–5 days and reached a relative risk of 1.435 (95%CI: 1.048–1.965), while no significant cumulative effect of low AT was observed. There was a significant effect of high AT on emergency visits of MDs due to psychoactive substance use and male patients. Conclusions Both low and high AT are demonstrated to be the significant risk factors of MDs, which highlights the need of strengthening the health interventions, patient medical services and early warning for patients.

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Maximum Temperature and Solar Radiation as Predictors of Bipolar Patient Admission in an Emergency Psychiatric Ward

Cited by 25 publications

References 51 publications

Rate of change in solar insolation is a hidden variable that influences seasonal alterations in bipolar disorder

Rate of change in solar insolation is a hidden variable that influences seasonal alterations in bipolar disorder

Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: A time-series study

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