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. 2020 Dec 7;17(23):9122.
doi: 10.3390/ijerph17239122.

Mental Health Disorders and Summer Temperature-Related Mortality: A Case Crossover Study

Elisa Stivanello  1 , Federico Chierzi  2 , Paolo Marzaroli  1 , Sara Zanella  3 , Rossella Miglio  3 , Patrizia Biavati  1 , Vincenza Perlangeli  1 , Domenico Berardi  4 , Angelo Fioritti  2 , Paolo Pandolfi  1
Affiliations

Mental Health Disorders and Summer Temperature-Related Mortality: A Case Crossover Study

Elisa Stivanello et al. Int J Environ Res Public Health. .

Abstract

Identifying the most vulnerable subjects is crucial for the effectiveness of health interventions aimed at limiting the adverse consequences of high temperatures. We conducted a case crossover study aimed at assessing whether suffering from mental health disorders modifies the effect of high temperatures on mortality. We included all deaths occurred in the area of Bologna Local Health Trust during the summers 2004-2017. Subjects with mental disorders were identified by using the local Mental Health Registry. A conditional logistic model was applied, and a z-test was used to study the effect modification. Several models were estimated stratifying by subjects' characteristics. For every 1 °C above 24 °C, mortality among people without mental disorders increased by 1.9% (95% CI 1.0-2.6, p < 0.0001), while among mental health service users, mortality increased by 5.5% (95% CI 2.4-8.6, p < 0.0001) (z-test equal to p = 0.0259). The effect modification varied according to gender, residency and cause of death. The highest probability of dying due to an increase in temperature was registered in patients with depression and cognitive decline. In order to reduce the effects of high temperatures on mortality, health intervention strategies should include mental health patients among the most vulnerable subjects taking account of their demographic and clinical characteristics.

Keywords: heat waves; high temperature; mental health; vulnerability.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prediction of death in the study populations according to apparent temperature at lag 0–1.
See this image and copyright information in PMC

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