Seasonal variations in hospital admissions for mania: Examining for associations with weather variables over time
Abstract
Background Bipolar disorder is characterized by a seasonal pattern with emerging evidence that weather conditions may trigger symptoms. Thus, our aims were to investigate if year-to-year variations in admissions with mania correlated with year-to-year variations in key meteorological variables, if there was a secular trend in light of climate change and if gender or admission status influenced the seasonal pattern.Methods We undertook a Danish register-based nationwide historical cohort study. We included all adults hospitalized to psychiatric care from 1995 to 2012 with mania using the Danish Psychiatric Central Research Register. The Danish Meteorological Institute provided the meteorological variables. The association between weather and admissions was tested using linear regression.Results Our database comprised 24,313 admissions with mania. There was a seasonal pattern with admission rates peaking in summer. Higher admission rates were associated with more sunshine, more ultraviolet radiation, higher temperature and less snow but were unassociated with rainfall. We did not find a secular trend in the seasonal pattern. Finally, neither gender nor admission status impacted on the overall seasonal pattern of admissions with mania.Limitations Only patients in psychiatric care were included. We could not subdivide by type of bipolar disorder.Conclusion This cohort study based on more than 24,000 admissions identified a distinct seasonal pattern in hospital admissions for those with mania. We found no secular trend. This could indicate that the climate change is not impacting on seasonal patterns, that there is no link between the proposed variables or that change is currently not sufficiently distinctive.
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Mood symptoms can occur in a seasonal pattern, as in seasonal affective disorder and in many cases of bipolar disorder.
“Mood symptoms can also occur in a seasonal pattern, as in seasonal affective disorder and in many cases of bipolar disorder192,193”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [193]
Cites
International Classification of Diseases
Jones, F. A. (1978) · Gut · doi:10.1136/gut.19.12.1175 · Cited by 2,919 · see citing works
Climate change and human health: present and future risks
McMichael, A. J., Woodruff, R. E., & Hales, S. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68079-3 · Cited by 2,585 · see citing works
The Danish Psychiatric Central Research Register
Mors, O., Perto, G. P., & Mortensen, P. B. (2011) · Scandinavian Journal of Public Health · doi:10.1177/1403494810395825 · Cited by 1,589 · see citing works
Supersensitivity to light: possible trait marker for manic-depressive illness
Lewy, A. J., Nürnberger, J. I., Wehr, T. A., Pack, D., Becker, L. E., Powell, R. L., & Newsome, D. A. (1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.6.725 · Cited by 284 · see citing works
Geoffroy, P. A., Bellivier, F., Scott, J., & Etain, B. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.07.002 · Cited by 251 · see citing works
Women with bipolar illness: clinical and research issues
Leibenluft, E. (1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.2.163 · Cited by 243 · see citing works
ten Have, M., Vollebergh, W., Bijl, R. V., & Nolen, W. A. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00310-4 · Cited by 212 · see citing works
Seasonal Variation in Depressive Disorders and Suicidal Deaths in New South Wales
Parker, G. B., & Walter, S. D. (1982) · The British Journal of Psychiatry · doi:10.1192/bjp.140.6.626 · Cited by 210 · see citing works
Self-citationEFFECT OF LIGHT WAVELENGTH ON SUPPRESSION AND PHASE DELAY OF THE MELATONIN RHYTHM
Wright, H. R., & Lack, L. C. (2001) · Chronobiology International · doi:10.1081/cbi-100107515 · Cited by 210 · see citing works
International Classification of Diseases
Musen, M. A. (2013) · Springer eBooks · doi:10.1007/978-1-4419-9863-7_1513 · Cited by 204 · see citing works
Pathophysiology of seasonal affective disorder: a review.
(2000) · PubMed Central · Cited by 190 · see citing works
Register-based studies of mental disorders
Munk‐Jørgensen, P., & Østergaard, S. D. (2011) · Scandinavian Journal of Public Health · doi:10.1177/1403494810390728 · Cited by 132 · see citing works
Self-citationMelatonin Sensitivity to Dim White Light in Affective Disorders
Nathan, P. J. (1999) · Neuropsychopharmacology · doi:10.1016/s0893-133x(99)00018-4 · Cited by 114 · see citing works
The seasonal incidence of mania and its relationship to climatic variables
Myers, D. H., & Davies, P. H. O. (1978) · Psychological Medicine · doi:10.1017/s003329170001610x · Cited by 112 · see citing works
Seasonal Variation in the Incidence of Mania
Symonds, R. L., & Williams, P. R. (1976) · The British Journal of Psychiatry · doi:10.1192/bjp.129.1.45 · Cited by 107 · see citing works
Lee, H., Tsai, S., & Lin, H. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.06.026 · Cited by 98 · see citing works
Influence of Climate on the Prevalence of Mania
Carney, P. A., Fitzgerald, C., & Monaghan, C. E. (1988) · The British Journal of Psychiatry · doi:10.1192/bjp.152.6.820 · Cited by 97 · see citing works
Gender differences in depression severity and symptoms across depressive sub-types
Parker, G. B., Fletcher, K., Paterson, A., Anderson, J., & Hong, M. P. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.06.018 · Cited by 93 · see citing works
Self-citationSeasonal changes, sleep length and circadian preference among twins with bipolar disorder
Rintamäki, R. M., Johansson, C. H., Kieseppä, T., Partonen, T., Koskenvuo, M. J., Kaprio, J. A., & Lönnqvist, J. K. (2003) · BMC Psychiatry · doi:10.1186/1471-244x-3-6 · Cited by 83 · see citing works
The precipitants of manic/hypomanic episodes in the context of bipolar disorder: A review
Proudfoot, J. G., Doran, J., Manicavasagar, V. L., & Parker, G. B. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.10.051 · Cited by 75 · see citing works
Self-citationSeasonal variations in hospital admissions for affective disorders by gender and ethnicity
Suhail, K., & Cochrane, R. (1998) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050045 · Cited by 74 · see citing works
Seasonal variation of mixed and pure episodes of bipolar disorder
Cassidy, F., & Carroll, B. J. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00325-6 · Cited by 69 · see citing works
Triggers of mania and depression in young adults with bipolar disorder
Proudfoot, J. G., Whitton, A. E., Parker, G. B., Doran, J., Manicavasagar, V. L., & Delmas, K. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.05.052 · Cited by 68 · see citing works
Self-citationMania and seasonality in the southern hemisphere
Sayer, H., Marshall, S. W., & Mellsop, G. W. (1991) · Journal of Affective Disorders · doi:10.1016/0165-0327(91)90027-p · Cited by 58 · see citing works
Seasonality of admissions for mania in a psychiatric hospital of Belo Horizonte, Brazil
Volpe, F. M., & Del-Porto, J. A. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.03.025 · Cited by 57 · see citing works
Effects of season and climate on the first manic episode of bipolar affective disorder in Korea
Lee, H., Kim, L., Joe, S.-H., & Suh, K.-Y. (2002) · Psychiatry Research · doi:10.1016/s0165-1781(02)00237-8 · Cited by 54 · see citing works
Dominiak, M., Święcicki, Ł., & RYBAKOWSKI, J. K. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.07.011 · Cited by 53 · see citing works
McKenna, B. S., Drummond, S. P. A., & Eyler, L. T. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.04.034 · Cited by 52 · see citing works
Relative Humidity and Manic Admissions in the London Area
Mawson, D. C., & Smith, A. J. (1981) · The British Journal of Psychiatry · doi:10.1192/bjp.138.2.134 · Cited by 48 · see citing works
Seasonal Variation in Bipolar Disorder
Partonen, T., & Lönnqvist, J. K. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.169.5.641 · Cited by 47 · see citing works
Mortality and secular trend in the incidence of bipolar disorder
Medici, C. R., Videbech, P., Gustafsson, L. N., & Munk‐Jørgensen, P. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.04.032 · Cited by 41 · see citing works
Self-citationDaily weather variables and affective disorder admissions to psychiatric hospitals
McWilliams, S., Kinsella, A., & O’Callaghan, E. (2014) · International Journal of Biometeorology · doi:10.1007/s00484-014-0805-9 · Cited by 40 · see citing works
Fifty years' development and future perspectives of psychiatric register research
Munk‐Jørgensen, P., Okkels, N., Golberg, D., Ruggeri, M., & Thornicroft, G. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12281 · Cited by 39 · see citing works
Self-citationINCIDENCE OF DEPRESSIVE SYNDROMES IN A DANISH COUNTY
Weeke, A., Bille, M., Videbech, T., et al. (1975) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1975.tb00210.x · Cited by 37 · see citing works
Further evidence of seasonality of mania in the tropics
Volpe, F. M., da Silva, E. M., dos Santos, T. N., et al. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.11.001 · Cited by 30 · see citing works
Meteorologic factors and subjective sleep continuity: a preliminary evaluation
Pandey, J., Grandner, M., Crittenden, C., Smith, M. T., & Perlis, M. L. (2005) · International Journal of Biometeorology · doi:10.1007/s00484-004-0227-1 · Cited by 28 · see citing works
The Relationship Between Bipolar Disorder, Seasonality, and Premenstrual Symptoms
Kim, D. R., Czarkowski, K. A., & Epperson, C. N. (2011) · Current Psychiatry Reports · doi:10.1007/s11920-011-0233-z · Cited by 28 · see citing works
Kerr-Corrêa, F., Souza, L. B., & Calil, H. M. (1998) · Psychopathology · doi:10.1159/000029049 · Cited by 26 · see citing works
Seasonal variation in bipolar disorder
Pio-Abreu, J. L. (1997) · The British Journal of Psychiatry · doi:10.1192/bjp.170.5.483c · Cited by 8 · see citing works
[The incidence of manic-depressive disorders].
Nielsen, J., & Nielsen, J. A. (1977) · PubMed · Cited by 2 · see citing works
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Logan, R. W., & McClung, C. A. (2019) · Nature Reviews Neuroscience · doi:10.1038/s41583-018-0088-y · Cited by 713 · see citing works
Thompson, R., Hornigold, R., Page, L., & Waite, T. (2018) · Public Health · doi:10.1016/j.puhe.2018.06.008 · Cited by 515 · see citing works
Climate change and mental health research methods, gaps, and priorities: a scoping review
Hwong, A. R., Wang, M., Khan, H., Chagwedera, D. N., Grzenda, A., Doty, B., Benton, T., Alpert, J., Clarke, D., & Compton, W. M. (2022) · The Lancet Planetary Health · doi:10.1016/s2542-5196(22)00012-2 · Cited by 154 · see citing works
- Authors
- Medici, C. R., Vestergaard, C. H., Hadzi-Pavlovic, D., Munk-Jørgensen, P., & Parker, G.
- Affiliations
- Aarhus University Hospital (DK)
- Black Dog Institute (AU)
- Corresponding author
- Medici, Clara Reece
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 205
- Pages
- 81-86
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2472667268
- Cited by
- 56
- References
- 40
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 5 · 2019: 5 · 2018: 7 · 2017: 3
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- mania, bipolar disorder, seasonal variation, hospitalization, weather, sunshine, ultraviolet radiation, temperature, snow, rainfall, climate change, secular trends, gender differences, psychiatric hospitalization
- MeSH terms
- Adolescent, Adult, Aged, Bipolar Disorder, Denmark, Female, Hospitalization, Humans, Male, Middle Aged, Rain, Registries, Seasons, Sex Factors, Snow, Sunlight, Temperature, Ultraviolet Rays, Weather, Cohort Studies, Young Adult, Climate Change
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