title: A positive relationship between ambient temperature and bipolar disorder identified using a national cohort of psychiatric inpatients.
abstract: OBJECTIVE
  This study characterizes the positive relationship between daily temperature and bipolar disorder in a cohort of Taiwanese psychiatric inpatients.
  
  
  METHODS
  Meteorological data, provided by the Central Weather Bureau (CWB) of Taiwan, were interpolated to create representative estimates of mean diurnal temperatures for 352 townships. Psychiatric inpatient admissions enrolled in the national health-care insurance system were retrieved from the 1996-2007 Psychiatric Inpatient Medical Claim (PIMC) dataset. The generalized linear mixed models with Poisson distribution were used to evaluate the relative risks of mean diurnal temperature with respect to increased admissions for bipolar disorder, while adjusting for internal correlations and demographic covariates.
  
  
  RESULTS
  Increased relative risks of bipolar disorder admissions were associated with the increasing trends of temperature over 24.0 °C (50th ‰), especially for adults and females. The highest daily diurnal temperatures above 30.7 °C (99th ‰) had the greatest risks of bipolar hospitalizations.
  
  
  CONCLUSIONS
  Understanding the increase of bipolar disorder admissions occurring in extreme heat is important in the preparation and prevention of massive recurrences of bipolar episodes.
authors: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Rd, Tainan 704, Taiwan.
authors: Tzu-I
authors: TI
authors: Sung
authors: Mu-Jean
authors: MJ
authors: Chen
authors: Huey-Jen
authors: HJ
authors: Su
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007231:Infant, Newborn; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D012042:Registries; D012306:Risk; D013624:Taiwan / Q000453:epidemiology; D013696:Temperature; D013997:Time Factors; D055815:Young Adult