Extreme heat can increase mental health ED visit rates

Extreme heat exposure appeared to be associated with increased mental health-related ED visit rates, according to the results of a case crossover study published in. JAMA Psychiatry.

“Ambient temperature previously exacerbated many mental and behavioral disorders symptoms, including the detrimental consequences of self-reported mental health, and ED for mental health causes, mood anxiety disorders, substance use, and schizophrenia. It has been associated with an increased risk of visits. It also increases the risk of suicide. ” Amruta Nori-Sarma, PhD, MPH, Written by members of the Faculty of Environmental Health, Boston University School of Public Health, and colleagues. “However, existing studies have been limited by small sample sizes, specific populations or geographic areas, or self-reported dependence on mental health symptoms.

“Therefore, the association between heat and mental health has not yet been fully quantified, increasing the risk factors for certain population subgroups to visit ED for mental health diagnosis due to exposure to higher ambient temperatures. Little is known about whether or not they did, “they added.

To address the gap in this study, Nori-Sarma and colleagues analyzed medical billing data from a single database and analyzed primary or secondary discharges from May to September 2010-2019. Identified a request for an ED visit with a psychiatric diagnosis. Elderly people with commercial or Medicare Advantage health insurance who live in 2,775 counties in the United States and exclude ED visits for screening for mental health consequences and impulse control disorders.

In addition, they have daily occurrences of cause-specific mental health diagnostics and composite endpoints and mental health diagnostics by identifying ED visit claims according to the primary and secondary discharge diagnostics ICD-9 and ICD-10 codes. I evaluated the rate.

Nori-Sarma et al. Included data on 3,496,762 ED visits from 2,243,395 unique individuals (56.8% female, mean age 51 years), of which 14.3% were 18-26 years old and 25.6% were 27-44 years old. , 33.3% were 45-64 years old and 26.8% were 65 years old or older. Result is, Extremely high temperature The incidence ratio of ED visits in mental health status is 1.08 (95% CI, 1.07-1.09). Researchers have noted an association between extreme fever and ED visits for certain mental health conditions, including delusional disorder (IRR = 1.08; 95% CI, 1.07-1.1); anxiety, stress-related and physical. Expressive disorder (IRR = 1.07; 95% CI, 1.05-1.09); Mood disorder (IRR = 1.07; 95% CI, 1.05-1.09); Schizophrenia, schizophrenia type and delusional disorder (IRR = 1.05; 95% CI, 1.03-1.07); Self-injurious behavior (IRR = 1.06; 95% CI, 1.01-1.12); and childhood-onset behavioral disorders (IRR = 1.11; 95% CI, 1.05-1.18). In addition, they are male (IRR = 1.1; 95% CI, 1.08-1.12) and individuals in the Northeastern United States (IRR = 1.1; 95% CO, 1.07-1.13), Midwest (IRR = 1.11; 95% CI). We have found a higher association between. , 1.09-1.13) and northwest (IRR = 1.12; 95% CI, 1.03-1.21) region.

“The results of this case crossover study suggest that there was an association between elevated ambient temperature and ED visits for all mental health conditions and specific mental health diagnoses,” Nori-Sarma et al. Is writing. “This finding may help clinicians providing mental health services prepare for increasing health service needs when high ambient temperatures are expected. Further research reveals extreme heat (heat waves). You can investigate the effect of duration of) on health outcomes and continue to investigate the relationships between different populations. “

In a related editorial, Nick Obradovich, PhD, Of the Max Planck Institute for Human Development in Germany Kelton Miner, MS, Of the Copenhagen Center for Social Data Science, University of Copenhagen, Denmark Climate change as a whole.

“So far, the collection of scientific and clinical knowledge is sparse compared to the threat concerns that climate change poses to human mental health,” they write. “We need more mental health scientists and clinicians to tackle this topic. Humanity needs your help. It’s as bad as a particular climate stressor already exists, but This is really just the beginning. “

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