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Ambient temperature and emergency department visits for mental disorder before and during the COVID-19 pandemic

Nature Mental Health volume 2, pages 278–286 (2024)Cite this article

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Abstract

Ambient temperature and the COVID-19 pandemic have both been increasingly associated with mental health issues in many regions of the world, but little is known about the potential role of this pandemic in modifying the association between increased temperature and effects on mental health disorders. We analyzed and compared the associations of mental health disorders (schizophrenia, depression, anxiety, and bipolar disorder) with short-term temperature changes (daily mean temperature and diurnal temperature range) before and during the COVID-19 pandemic in an eastern Chinese city (Hefei). Mean temperature rise (per 1 °C increase) and high diurnal temperature range (99th percentile compared with risk-surge point of diurnal temperature range) were associated with increased risk of emergency department visits for schizophrenia and depression. The effect of mean temperature and diurnal temperature range on depression-related visits was significantly greater during the pandemic than before, whereas there were no significant differences in the effects of temperature changes on emergency department visits for other mental health disorders between the pre-pandemic and pandemic periods. This study provides additional evidence that the COVID-19 pandemic may have modified the effects of short-term temperature changes on mental health disorders, especially depression.

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Fig. 1: The association between cause-specific MHDs and mean temperature and between cause-specific MHDs and DTR before and during the COVID-19 pandemic.
Fig. 2: The association between cause-specific MHDs and ambient temperature among men and women.
Fig. 3: The association between cause-specific MHDs and ambient temperature among younger and older groups.

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Data availability

Daily emergency department visits for mental health disorders are not authorized to be shared. Hourly meteorological data can be obtained at https://doi.org/10.24381/cds.e2161bac. Daily temperature data from the monitoring station can be obtained at https://www.ncdc.noaa.gov. Hourly air pollutant data can be obtained by submitting the data request to China National Environmental Monitoring Centre (http://www.cnemc.cn/). Estimated annual population data are available from https://doi.org/10.5258/SOTON/WP00647.

Code availability

Codes for data analysis are given in Supplementary Methods 1.

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Acknowledgments

This research is funded by the National Natural Science Foundation of China (grant number: 42105165 to J.C.), the High-level Scientific Research Foundation of Anhui Medical University (grant number: 0305044201 to J.C.), and the Discipline Construction of Anhui Medical University (grant number: 0301001836 to J.C.).

Author information

Author notes

  1. These authors contributed equally: Keyu Wu, Junwei Yan, Min Yang, Qiyue Wu.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China

    Keyu Wu, Min Yang, Qiyue Wu, Junwen Tao, Hong Su & Jian Cheng

  2. Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China

    Keyu Wu, Min Yang, Qiyue Wu, Junwen Tao, Hong Su & Jian Cheng

  3. Affiliated Psychological Hospital of Anhui Medical University, Hefei, China

    Junwei Yan, Qingrong Xia & Cuizhen Zhu

  4. Anhui Mental Health Center, Hefei, China

    Junwei Yan, Qingrong Xia & Cuizhen Zhu

  5. Hefei Fourth People’s Hospital, Hefei, China

    Junwei Yan, Qingrong Xia & Cuizhen Zhu

  6. Anhui Clinical Research Center for Mental Disorders, Hefei, China

    Junwei Yan, Qingrong Xia & Cuizhen Zhu

  7. Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China

    Hao Zheng

  8. School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China

    Xiling Wang

  9. Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China

    Xiling Wang

  10. International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh

    Mohammad Zahid Hossain

  11. National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

    Ning Wang

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Contributions

J.C. conceived and designed the study. J.Y., M.Y., Q.X., and C.Z. collected and organized data. K.W. and Q.W. performed the analysis. K.W., H.Z., X.W., J.T., and M.Z.H. contributed to the interpretation of the findings. K.W. wrote the first draft of the manuscript. J.C., N.W., and H.S. edited the manuscript. K.W., M.Y., and Q.W. contributed to visualization. J.C. has verified the data and taken responsibility for the decision to submit the manuscript. All authors read and approved the final version of the manuscript and ensure it is the case.

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Correspondence to Jian Cheng.

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Nature Mental Health thanks Francesco Sera and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Supplementary Figs. 1–3, Tables 1–6, and Methods 1.

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Wu, K., Yan, J., Yang, M. et al. Ambient temperature and emergency department visits for mental disorder before and during the COVID-19 pandemic. Nat. Mental Health 2, 278–286 (2024). https://doi.org/10.1038/s44220-023-00193-y

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