Is greater temperature change within a day associated with increased emergency admissions for schizophrenia?
BACKGROUND
Diurnal temperature range (DTR), as an important index of climate change, has been increasingly used to evaluate the impacts of temperature variability on human health. However, little is known about the effects of DTR on schizophrenia.


OBJECTIVE
The present study aims to examine the relationship between DTR and schizophrenia admissions, and further, to explore whether the association varied by individual characteristics and study periods.


METHODS
A Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) was applied to analyze daily DTR and schizophrenia data from Hefei, China during 2005 to 2014, after adjusting for long-term and seasonal trends, mean temperature, relative humidity and other confounding factors.


RESULTS
An acute adverse effect of extremely high DTR on schizophrenia was observed, with a 2.7% (95% CI: 1.007-1.047) increase of daily schizophrenia admissions after exposure to extremely high DTR (95th percentile vs. 50th percentile). The risk for schizophrenia onset due to large DTR exposure increased from the first five years (2005-2009) to the second five years (2010-2014). Additionally, the patient aged 15-29 and 50-64years, male patients, patients born in spring/autumn, and married patients appeared to be more vulnerable to DTR effect. However, there was no significant association between moderately high DTR (75th percentile) and schizophrenia.


CONCLUSIONS
This study suggests that extremely high DTR is a potential trigger for schizophrenia admissions in Hefei, China. Our findings may provide valuable information to decisions-makers and guidance to health practitioners.
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Desheng
D
Zhao
Anhui Mental Health Center, Hefei, Anhui Province, China.
Xulai
X
Zhang
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Mingyu
M
Xie
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Jian
J
Cheng
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Heng
H
Zhang
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Shusi
S
Wang
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Kesheng
K
Li
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Huihui
H
Yang
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Liying
L
Wen
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.
Xu
X
Wang
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China. Electronic address: suhong5151@sina.com.
Hong
H
Su
D000367:Age Factors; D002681:China; D002940:Circadian Rhythm; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D017533:Marital Status; D017711:Nonlinear Dynamics; D016012:Poisson Distribution; D012559:Schizophrenia / Q000453:epidemiology* / Q000209:etiology; D012737:Sex Factors; D013696:Temperature
Admission; Diurnal temperature range; Schizophrenia