Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Δουζένης Αθανάσιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σμυρνής Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γουρνέλλης Ρωσσέτος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μιχόπουλος Ιωάννης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μισουρίδου Ευδοκία, Αναπληρώτρια Καθηγήτρια, Σχολή Επιστημών Υγείας και Πρόνοιας, ΠΑΔΑ
Πανταζής Νικόλαος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Λαγουβάρδος Κώστας, Διευθυντής Ερευνών, Ινστιτούτο Ερευνών Περιβάλλοντος και Βιώσιμης Ανάπτυξης, ΕΑΑ
Original Title:
Διερεύνηση της σχέσης μεταξύ εποχικότητας, μετεωρολογικών παραμέτρων και ακούσιας νοσηλείας ψυχικά ασθενών
Translated title:
Study of the relationship between seasonality, meteorological parameters and involuntary psychiatric hospitalization
Summary:
Introduction: Few studies in the literature have examined the effect of seasonality and meteorological factors, especially temperature, on psychiatric hospitalization and even less on their association with involuntary admission.
This study aimed to investigate the potential association of seasonality and meteorological factors with the involuntary psychiatric hospitalization in the region of Attica, Greece. The research was conducted at the Psychiatric Hospital of Attica "Dafni". This was a retrospective time series study of 8 consecutive years of data (2010 to 2017) and included 6887 involuntarily hospitalized patients. Data on daily meteorological parameters were provided from the National Observatory of Athens.
Method: Seasonal pattern and long term trend in hospital admission were examined statistically and analyzed using Poisson models with robust standard errors including 1-year period Fourier terms and a linear time term. Statistical analysis of meteorological factor was based on Poisson or negative binomial regression models with adjusted standard errors. Analyses were initially based on univariable models for each meteorological factor separately. All meteorological factors were taken into account through factor analysis and then, through cluster analysis, an objective grouping of days with similar weather type was performed. The resulting types of days were examined for their effect on the daily number of involuntary hospitalizations.
Results: Maximum (+6.5%) and minimum (-6.1%) within year values of involuntary admission were estimated to occur during mid June and mid December respectively, with no significant differences when controlled for sex, age or diagnosis. Estimated long term trend corresponded to a 4% increase in admissions per year. Long term increasing trends were more pronounced in the F11-F19 (mental and behavioral disorders due to psychoactive drug use) and F00-F09 (organic, including symptomatic, mental disorders) diagnoses groups and in the youngest (16-29 years) and oldest (65+ years) groups.
Increases in maximum temperature, in average wind speed and in minimum atmospheric pressure values were associated with an increase in the average number of involuntary hospitalizations per day. Increase of the maximum temperature above 23 °C did not affect significantly the frequency of involuntary hospitalizations. Low temperature and average relative humidity above 60% levels had a protective effect.
The predominant day type at lag 1 to 5 days before admission showed the strongest correlation with the daily number of involuntary hospitalizations. The cold season day type, with a low daily temperature for the season and a small diurnal temperature range, northerly winds of moderate speed, high atmospheric pressure and almost no precipitation, is associated with the lowest frequency of involuntary hospitalizations, whereas the warm season day type, with low daily temperature and small daily temperature range during the warm season, high values of relative humidity and daily precipitation, moderate wind speed/gust and atmospheric pressure, was associated with the highest. The results were more pronounced in the F00-F09 diagnoses groups and in the oldest (65+ years) group.
Conclusion: As climate change increases the frequency of extreme weather events, it is necessary to develop a different organizational and administrative culture of mental health services.
Main subject category:
Health Sciences
Keywords:
Seasonality, Meteorological factors, Weather variables, Mental disorder, Involuntary hospitalization
Number of references:
373
