METHODS: This case-crossover study included emergency department (ED) visits and hospital encounters with a primary diagnosis of any mental health disorder during warm-season months (June-August) in New York City from 2005 to 2011 from patients of three age groups (6-11, 12-17 and 18-25 years). Using a distributed lag non-linear model over 0-5 lag days, by fitting a conditional logistic regression for each age group, we calculated the cumulative odds ratios of mental health encounters associated with an elevated temperature. Analyses were stratified by race/ethnicity, payment source and mental health categories to elucidate vulnerable subpopulations.
RESULTS: In New York City, there were 82,982 mental health-related encounters for young people aged 6 to 25 years during our study period months. Elevated temperature days were associated with higher risk of mental health-related ED and hospital encounters for the 6- to 11-year-olds (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.13-1.46), for the 12- to 17-year-olds (OR: 1.17, 95% CI: 1.09-1.25) and for the 18- to 25-year-olds (OR: 1.09, 95% CI: 1.04-1.15). Children with reaction disorders, adolescents with anxiety and bipolar disorders, young adults with psychosis and reaction disorders and Black and non-Hispanic children and adolescents showed vulnerability to elevated temperature.
CONCLUSIONS: We found that elevated ambient temperatures were associated with acute mental health ED or hospital encounters across childhood, adolescence and young adulthood.
方法:这项病例交叉研究包括2005年至2011年在纽约市温暖季节(6-11岁、12-17岁和18-25岁)的患者中急诊(ED)就诊和在医院遇到任何心理健康障碍的主要诊断。使用0-5个滞后天的分布式滞后非线性模型,通过拟合每个年龄组的条件逻辑回归,我们计算了与体温升高相关的精神健康事件的累积比值比.分析按种族/族裔分层,支付来源和心理健康类别,以阐明脆弱的亚群。
结果:在纽约市,在我们的研究期间,6至25岁的年轻人有82,982次与心理健康相关的遭遇。温度升高的天数与6至11岁儿童的心理健康相关ED和住院风险较高相关(比值比[OR]:1.28,95%置信区间[CI]:1.13-1.46),对于12至17岁(OR:1.17,95%CI:1.09-1.25)和18至25岁(OR:1.09,95%CI:1.04-1.15)。有反应障碍的儿童,患有焦虑和双相情感障碍的青少年,患有精神病和反应障碍的年轻人以及黑人和非西班牙裔儿童和青少年表现出体温升高的脆弱性。
结论:我们发现,环境温度升高与儿童时期的急性心理健康ED或医院接触有关,青春期和年轻的成年。