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      The Effect of Heat Waves on Mental Health in a Temperate Australian City


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          The goal of this study was to identify mental, behavioral, and cognitive disorders that may be triggered or exacerbated during heat waves, predisposing individuals to heat-related morbidity and mortality.


          Using health outcome data from Adelaide, South Australia, for 1993–2006, we estimated the effect of heat waves on hospital admissions and mortalities attributed to mental, behavioral, and cognitive disorders. We analyzed data using Poisson regression accounting for overdispersion and controlling for season and long-term trend, and we performed threshold analysis using hockey stick regression.


          Above a threshold of 26.7°C, we observed a positive association between ambient temperature and hospital admissions for mental and behavioral disorders. Compared with non–heat-wave periods, hospital admissions increased by 7.3% during heat waves. Specific illnesses for which admissions increased included organic illnesses, including symptomatic mental disorders; dementia; mood (affective) disorders; neurotic, stress related, and somatoform disorders; disorders of psychological development; and senility. Mortalities attributed to mental and behavioral disorders increased during heat waves in the 65- to 74-year age group and in persons with schizophrenia, schizotypal, and delusional disorders. Dementia deaths increased in those up to 65 years of age.


          Our results suggest that episodes of extreme heat pose a salient risk to the health and well-being of the mentally ill.

          Relevance to Clinical or Professional Practice: Improvements in the management and care of the mentally ill need to be addressed to avoid an increase in psychiatric morbidity and mortality as heat waves become more frequent.

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          Most cited references59

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          Heat Stroke

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            Heat-related and cold-related deaths in England and Wales: who is at risk?

            Despite the high burden from exposure to both hot and cold weather each year in England and Wales, there has been relatively little investigation on who is most at risk, resulting in uncertainties in informing government interventions. To determine the subgroups of the population that are most vulnerable to heat-related and cold-related mortality. Ecological time-series study of daily mortality in all regions of England and Wales between 1993 and 2003, with postcode linkage of individual deaths to a UK database of all care and nursing homes, and 2001 UK census small-area indicators. A risk of mortality was observed for both heat and cold exposure in all regions, with the strongest heat effects in London and strongest cold effects in the Eastern region. For all regions, a mean relative risk of 1.03 (95% confidence interval (CI) 1.02 to 1.03) was estimated per degree increase above the heat threshold, defined as the 95th centile of the temperature distribution in each region, and 1.06 (95% CI 1.05 to 1.06) per degree decrease below the cold threshold (set at the 5th centile). Elderly people, particularly those in nursing and care homes, were most vulnerable. The greatest risk of heat mortality was observed for respiratory and external causes, and in women, which remained after control for age. Vulnerability to either heat or cold was not modified by deprivation, except in rural populations where cold effects were slightly stronger in more deprived areas. Interventions to reduce vulnerability to both hot and cold weather should target all elderly people. Specific interventions should also be developed for people in nursing and care homes as heat illness is easily preventable.
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              Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence.


                Author and article information

                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                October 2008
                30 June 2008
                : 116
                : 10
                : 1369-1375
                [1 ] Discipline of Public Health, School of Population Health and Clinical Practice, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
                [2 ] South Australian Department of Health, Adelaide, South Australia, Australia
                Author notes
                Address correspondence to P. Bi, Discipline of Public Health, School of Population Health and Clinical Practice, Faculty of Health Sciences, Level 9, Tower Building, 10 Pulteney St., MPD 207, The University of Adelaide, South Australia, 5005 Australia. Telephone: 618-8303-3583. Fax: 618-8303-6885. E-mail: peng.bi@ 123456adelaide.edu.au

                The authors declare they have no competing financial interests.

                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                : 6 February 2008
                : 25 June 2008
                Environmental Medicine

                Public health
                mental health,schizophrenia,weather,heat waves,psychiatric,temperature,dementia
                Public health
                mental health, schizophrenia, weather, heat waves, psychiatric, temperature, dementia


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