title: Effects of ambient temperature on daily hospital admissions for mental disorders in Shanghai, China: A time-series analysis.
abstract: BACKGROUND
  Evidence for extreme ambient temperature effects on the risk of mental disorders (MDs) is limited. In this study, we evaluated the short-term effects of daily mean temperature on hospital admissions of MDs in Shanghai, China.
  
  
  METHODS
  We obtained daily hospital admission data for MDs, daily meteorological and ambient pollution data in Shanghai from January 2008 to December 2015. Adjusted for time trend, air pollution, relative humidity and other confounders, a quasi-Poisson generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was used to analyze the lag-exposure-response relationship between daily mean temperature and hospital admissions for MDs.
  
  
  RESULTS
  Total daily hospital admissions for MDs during the study period were 93,971. With a reference of median temperature (18.3°C), there was a significant positive association between the temperature above threshold (24.6°C) and MD hospital admission visits at a lag of 0-1days. The relative risks of extreme hot temperatures (33.1°C, 99% percentile) over the lag 0-1days compared to median temperature were 1.266 (95% confidence intervals: 1.074-1.493). No effect of cold weather on the hospital admissions for MDs was observed.
  
  
  CONCLUSIONS
  This study suggests that extreme hot temperature poses significant risks on MD; health counseling and cooling measures should be considered for the susceptible population.
authors.affiliation: Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.
authors.forename: Zhuoxin
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.affiliation: Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai, China. Electronic address: wwb@fudan.edu.cn.
authors.forename: Weibing
authors.initials: W
authors.lastname: Wang
mesh_terms: D002681:China / Q000453:epidemiology; D002947:Cities; D006760:Hospitalization; D006358:Hot Temperature; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*
keywords: Ambient temperature; Generalized additive model; Hospital admission; Hot effect; MD