title: Psychiatric morbidity in travelers to Honolulu, Hawaii.
abstract: To investigate the phenomenon of acute psychiatric decompensation in travelers, charts of all psychiatric-emergency patients with a history of recent travel involving time-zone changes were reviewed at a major medical center in Honolulu, HI. Charts of a control group with no history of travel were also reviewed. Significantly more travelers than controls showed symptoms of depression and mania (P < .012). East-bound travelers were significantly more likely to show symptoms of mania than controls (P < .001). In an eastbound-versus-westbound comparison, significantly more eastbound travelers showed symptoms of mania, whereas significantly more westbound travelers showed symptoms of depression (P < .05). These findings support the phase-advance hypothesis of depression. Psychosocial and biologic factors that may contribute to psychiatric decompensation in travelers are discussed.
authors.affiliation: Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu 96813, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Young
mesh_terms: D000208:Acute Disease; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009949:Orientation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D014195:Travel