Effects Of Increasing Temperature And Heatwave On Hospital Admission For Schizophrenia In Hefei,China

Objective: The purposes of this paper is to investigate the association between high temperature with schizophrenia hospital admission in Hefei,China,and explore potential vulnerable people(2)To explore the distribution characteristic of schizophrenia onset in Hefei from 2013 to 2016.(3)To investigate which heatwave definition is better fit the model.Method:To obtain the data on the daily data on hospital admission of schizophrenia from the Mental Health Center of Anhui Province during 2013-2016,and to collect the daily meteorological data provided by the Meteorological Bureau of Hefei at the same time period,including the maximum temperature(Max Tem)and minimum Temperature(Min Tem),mean temperature(Mean Tem),relative humidity(humidity),etc.,and daily pollutant data provided by Hefei City Environmental Monitoring Center,including particulate matter(PM2.5,PM10),carbon monoxide(CO),and sulfur dioxide(SO2),Nitrogen Dioxide(NO2),and Ozone(O3).Poisson generalized linear regression model combined with a distributed lag non-linear model was used to analyze the effects of heatwaves under different definitions on schizophrenia admission after adjusting for long-term and seasonal trends,relative humidity and other confounding factors.According to individual characteristics,such as age,gender and marital status,stratified analyses were also conducted.Results: In this paper,we found a significant relationship between ambient temperature and schizophrenia admissions.High temperature was appeared to have the delayed effects on schizophrenia.Comparison of 75 quantiles and 50 quantiles found that when the average temperature was 75 quartiles,the cumulative lag effect at0-4 days increased the risk of 8%.(95% confidence interval: 1%-17%).Stratified analyses showed that male patients,aged 21-60 years and married patients were more vulnerable to high temperature,and the temperature effects for male,aged 21-40 and married patients occurred at the lag of 1 day,aged 41-60 patients occurred at the lag of 1 day.Different heatwaves definitions resulted in considerable differences in relationship between heat waves and schizophrenia admission.The heatwave effects were consistently found to be acute and RRs of schizophrenia admission at lag0 marginally fluctuated between 0.95 and 1.11.The strongest relationship is the model with heatwave defined as ?3 consecutive days with daily mean temperature ?95th percentile with an increase of 11%(95%CI: 2%-21%)total patients at the lag of 0 day.The best model fit(the lowest Q-ACI value)is the model with heatwave defined as ?2consecutive days with daily mean temperature?95th percentile,and increase of 10%(95%CI: 3%-21%)total patients at the lag of 0 day.Under different heatwaves definitions,effects of heatwaves on schizophrenia admission were higher for males versus females,the married patients versus unmarried patients,age of 21-60 appeared to be more vulnerable to heatwaves compared with age of 0-20 and above of 61.However,no significant effect of heatwaves defined as daily mean temperature ?99th percentile with ?2 consecutive days or ?3 consecutive days on the hospital admission for schizophrenia was observed.Conclusions:This study provides the evidence that high temperature poses significant risks on schizophrenia in a subtropical region.Heatwaves definition plays a critical role in the association between heatwaves with schizophrenia admission.Thus,it is time to have an effective evaluation on the impact of heatwave on public health,so as to develop local heat warming systems and carry out appropriate and effective interventions.The susceptible individuals with schizophrenia of we found should be given more attention and care while developing appropriate preventive measures.