title: Examining for any impact of climate change on the association between seasonality and hospitalization for mania.
abstract: Studies have established higher rates of hospitalization for mania in spring and summer and posit various explanatory climatic variables. As the earth's climate is changing, we pursue whether this is reflected in the yearly seasonal variation in hospitalizations for mania. This would be indicated by the presence of secular changes in both the hospitalization seasonal pattern and climatic variables, and associations between both variable sets.
  
  
  
  Data were obtained for 21,882 individuals hospitalized to psychiatric hospitals in the Australian state of New South Wales (NSW) over a 14-year period (2000-2014) with ICD-diagnosed mania - and with NSW population figures and salient climatic variables collected for the same period. Regression analyses were conducted to examine the predictive value of climate variables on hospital admissions.
  
  
  
  Data quantified a peak for manic admissions in spring of the southern hemisphere, in the months of October and November. There was a significant linear increase in manic admissions (0.5%/year) over the 14-year time period, with significant variation across years. In terms of climatic variables, there was a significant linear trend over the interval for solar radiation, although the trend indicated a decrease rather than an increase. Seasonal variation in admissions was most closely associated with two climate variables - evaporation in the current month and temperature in the previous month.
  
  
  
  Hospitalization rates do not necessarily provide an accurate estimate of the onset of manic episodes and findings may be limited to the southern hemisphere, or New South Wales.
  
  
  
  While overall findings do not support the hypothesis that climate change is leading to a higher seasonal impact for manic hospital admissions in the southern hemisphere, analyses identified two climate/weather variables - evaporation and temperature - that may account for the yearly spring excess.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia. Electronic address: g.parker@unsw.edu.au.
authors.forename: Gordon B
authors.initials: GB
authors.lastname: Parker
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia.
authors.forename: Dusan
authors.initials: D
authors.lastname: Hadzi-Pavlovic
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Graham
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology*; D057231:Climate Change; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D009517:New South Wales / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D012044:Regression Analysis; D012621:Seasons; D013696:Temperature; D014887:Weather
keywords: Bipolar disorder; Climate change; Hospitalization; Mania; Seasonality