[Impact of the summer 2003 heat wave on the activity of two psychiatric emergency departments]. / Impacto de la ola de calor del verano 2003 en la actividad de dos servicios de urgencias psiquiátricas.

INTRODUCTION: Heat waves have been related with lethal effects, especially in Europe during the intensely hot summer of 2003. However, besides increased deaths and ailments, there are no specific data on the psychiatric effects of heat waves. METHODS: We have compared psychiatric emergencies in Barcelona during a 15-day heat waves period with the rest of the 2003 summer days. The main variables of the study were total emergencies, admissions, diagnoses, Severity of Psychiatric Illness scale (SPI), psychosocial variables, treatment rendered (including use of restraints), and referrals. RESULTS: No differences were found in the number of emergencies and admissions. During the heat wave, there were more patients with psychiatric backgrounds, more diagnoses of alcohol and drug abuse, but fewer anxiety disorders. The proportion of patients with mechanical restraint increased, but this only occurred in half of the cases in patients with drug or alcohol abuse. The item "dangerousness toward others" (part of the SPI scale) scored significantly higher during the heat waves. CONCLUSIONS: There were no significant increases or decreases in psychiatric emergencies or admissions. However, the heat wave was related to more violent behavior and higher drug and alcohol abuse. It should be noted that anxiety conditions and benzodiazepine prescriptions were lower during this period. These findings may be useful to implement medical-psychiatric preventive measures against the heat wave phenomenon.

Impacto de la ola de calor del verano 2003 en la actividad de dos servicios de urgencias psiquiátricas / Impact of the summer 2003 heat wave on the activity of two psychiatric emergency departments

Introducción. La ola de calor se ha relacionado con efectos letales, especialmente en Europa durante el caluroso verano de 2003. Pero aparte del incremento de muertes y enfermedades, no existen datos específicos de los efectos psiquiátricos de la ola de calor. Metodología. Se compararon las urgencias psiquiátricas de dos hospitales de Barcelona durante los 15 días de la ola de calor con el resto del verano de 2003. Las principales variables del estudio fueron: urgencias totales, ingresos, diagnósticos, gravedad, variables psicosociales, tratamientos aplicados (incluyendo contención mecánica), y derivaciones. Resultados. No se encontraron diferencias en el número de urgencias ni de ingresos. Durante la ola de calor, hubo más pacientes con antecedentes psiquiátricos, más diagnóstico de abuso de alcohol y drogas, pero menos trastornos de ansiedad. También aumentó la proporción de pacientes con sujeción mecánica, pero sólo en la mitad de casos, esto ocurrió en pacientes con abuso de alcohol o drogas. El ítem «peligro hacia los demás» de la escala de gravedad se puntuó significativamente más alto en la ola de calor. Conclusiones. No hubo incrementos o disminuciones significativos en urgencias o los ingresos psiquiátricos, aunque los que acudieron tenían más antecedentes psiquiátricos. Durante la ola de calor hubo un cierto incremento significativo de violencia y de abuso de alcohol y drogas, pero menor porcentaje de trastornos de ansiedad y menos prescripciones de benzodiazepinas durante este período. Estos datos exploratorios indican el interés de considerar medidas preventivas médico psiquiátricas frente al fenómeno de la ola de calor (AU)

Introduction. Heat waves have been related with lethal effects, especially in Europe during the intensely hot summer of 2003. However, besides increased deaths and ailments, there are no specific data on the psychiatric effects of heat waves. Methods. We have compared psychiatric emergencies in Barcelona during a 15-day heat waves period with the rest of the 2003 summer days. The main variables of the study were total emergencies, admissions, diagnoses, Severity of Psychiatric Illness scale (SPI), psychosocial variables, treatment rendered (including use of restraints), and referrals. Results. No differences were found in the number of emergencies and admissions. During the heat wave, there were more patients with psychiatric backgrounds, more diagnoses of alcohol and drug abuse, but fewer anxiety disorders. The proportion of patients with mechanical restraint increased, but this only occurred in half of the cases in patients with drug or alcohol abuse. The item «dangerousness toward others» (part of the SPI scale) scored significantly higher during the heat waves. Conclusions. There were no significant increases or decreases in psychiatric emergencies or admissions. However, the heat wave was related to more violent behavior and higher drug and alcohol abuse. It should be noted that anxiety conditions and benzodiazepine prescriptions were lower during this period. These findings may be useful to implement medical-psychiatric preventive measures against the heat wave phenomenon (AU)

Panic anxiety, under the weather?

The relationship between weather conditions and psychiatric disorders has been a continuous subject of speculation due to contradictory findings. This study attempts to further clarify this relationship by focussing on specific conditions such as panic attacks and non-panic anxiety in relation to specific meteorological variables. All psychiatric emergencies attended at a general hospital in Barcelona (Spain) during 2002 with anxiety as main complaint were classified as panic or non-panic anxiety according to strict independent and retrospective criteria. Both groups were assessed and compared with meteorological data (wind speed and direction, daily rainfall, temperature, humidity and solar radiation). Seasons and weekend days were also included as independent variables. Non-parametric statistics were used throughout since most variables do not follow a normal distribution. Logistic regression models were applied to predict days with and without the clinical condition. Episodes of panic were three times more common with the poniente wind (hot wind), twice less often with rainfall, and one and a half times more common in autumn than in other seasons. These three trends (hot wind, rainfall and autumn) were accumulative for panic episodes in a logistic regression formula. Significant reduction of episodes on weekends was found only for non-panic episodes. Panic attacks, unlike other anxiety episodes, in a psychiatric emergency department in Barcelona seem to show significant meteorotropism. Assessing specific disorders instead of overall emergencies or other variables of a more general quality could shed new light on the relationship between weather conditions and behaviour.