Impact of temperature extremes on emergency department presentations for mental health disorders: a time-series study — The Association Specialists
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  3. Impact of temperature extremes on emergency department presentations for mental health disorders: a time-series study

Impact of temperature extremes on emergency department presentations for mental health disorders: a time-series study (24198)

Derrick Lopez 1 , Craig Cumming 1 , Giulietta Valuri 1 , Amanda Neil 2 , Anna Waterreus 1 , Colleen O'Leary 3 , David B Preen 1
  1. School of Population and Global Health, The University of Western Australia, Crawley, Western Australia
  2. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania
  3. Office of the Chief Psychiatrist, Perth, Western Australia

Background

Extremes of temperatures, in terms of hot and cold environmental conditions, may impact mental health (MH). We assessed the association between daily maximum temperature (Tmax) on emergency department (ED) presentations for MH disorders amongst residents of Perth.

Method

Data were extracted from the Western Australian ED Data Collection for presentations between 2010-2023, with meteorological data obtained from the Scientific Information for Land Owners dataset. The primary outcome measure was the relative risk (RR) (95% confidence interval) of ED presentations for MH disorders (ICD-10-AM: F00-F99) due to extreme hot (36.3°C, 95th percentile) and cold (16.9°C, 5th percentile) Tmax relative to the median Tmax (24.0°C), measuring effects delayed up to 14 days. Quasi-Poisson regression combined with a distributed lag non-linear model was used. Analyses were stratified by sex and age group.

Results

There were 304,004 ED presentations (51.1% female; 59.1% aged 25-64 years) for MH diagnoses. Following a hot day, the risk of ED presentations increased (RR=1.17 [1.11-1.23]) relative the median Tmax for all MH disorders across all cases. Following a cold day, the risk of ED presentations decreased for all age groups (RR=0.91 [0.87-0.96]) except those aged 65+ years (RR=1.05 [0.92-1.18]). Amongst the MH subgroups, risks of ED presentations increased following a hot day for neurotic (ICD-10-AM: F40-F49) and personality disorders (ICD-10-AM: F60-F69) for all cases (RR=1.18 [1.07-1.29]; RR=1.67 [1.25-2.24] respectively). Statistical inferences for other MH subgroups were not possible due to small case numbers.

Conclusion

The risk of MH-related ED presentations increased following hot days for the entire study population and particularly for those living with neurotic and personality disorders. As the intensity, duration and frequency of temperatures extremes are expected to increase with climate change, the translation of findings for public and clinical health will need to be prioritised.