Temperature-related deaths in people with psychosis, dementia and substance misuse
Open accessAbstract
Background: Climate change is expected to have significant effects on human health, partly through an increase in extreme events such as heatwaves. People with mental illness may be at particular risk. Aims: To estimate risk conferred by high ambient temperature on patients with psychosis, dementia and substance misuse. Method: We applied time-series regression analysis to data from a nationally representative primary care cohort study. Relative risk of death per 1° increase in temperature was calculated above a threshold. Results: Patients with mental illness showed an overall increase in risk of death of 4.9% (95% CI 2.0–7.8) per 1° increase in temperature above the 93rd percentile of the annual temperature distribution. Younger patients and those with a primary diagnosis of substance misuse demonstrated greatest mortality risk. Conclusions: The increased risk of death during hot weather in patients with psychosis, dementia and substance misuse has implications for public health strategies during heatwaves.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Heat-related mental health morbidity tends to occur most often in people with impaired thermoregulation: those with pre-existing mental health illness or problems, those taking prescription medications (lithium, neuroleptic, and anticholinergic drugs), and those with substance abuse problems.
“Scholars in the field note that heat-related mental health morbidity tends to occur most often in people with impaired thermoregulation, namely people with pre-existing mental health illness and problems, people taking prescription medications (specifically lithium, neuroleptic and anticholinergic drugs), and those with substance abuse (alcohol and drugs) problems [35, 36, 74].”
From Climate change and mental health: risks, impacts and priority actions (2018) · cites this paper as [36]
The Results and Public health implications sections (pages not provided) report increased heat-related mortality among patients with mental illness, particularly those with alcohol or substance misuse. The Medication section links antipsychotics to possible impaired temperature regulation, but the paper studies mortality rather than mental health morbidity; it does not establish impaired thermoregulation as the common cause or assess lithium or anticholinergic drugs as risk factors. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPeople taking certain psychotropic medications (including hypnotics, anxiolytics, and antipsychotics) are at increased risk of heatstroke and death as a result of high temperatures, possibly due to disruptions in thermoregulation triggered by some psychotropic medications.
“People taking certain psychotropic medications (including hypnotics, anxiolytics, and antipsychotics) are at increased risk of heatstroke and death as a result of high temperatures, possibly due to disruptions in thermoregulation triggered by some psychotropic medications [56,66].”
From Climate Change and Mental Health: A Scoping Review (2021) · cites this paper as [56]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredA study from England found that primary care patients with psychosis, dementia, and alcohol or substance misuse experienced significantly higher heat-related mortality above regionally defined temperature thresholds.
“A study from England found that primary care patients with psychosis, dementia, and alcohol or substance misuse experienced significantly higher heat-related mortality above regionally defined temperature thresholds.”
From Climate Change and Mental Health: A Scoping Review (2021) · cites this paper as [56]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Mackay, A. W. (2008) · Journal of Environmental Quality · doi:10.2134/jeq2008.0015br · Cited by 5,592 · see citing works
More Intense, More Frequent, and Longer Lasting Heat Waves in the 21st Century
Meehl, G. A., & Tebaldi, C. (2004) · Science · doi:10.1126/science.1098704 · Cited by 4,322 · see citing works
(1958) · Journal of the American Pharmaceutical Association (Scientific ed ) · doi:10.1002/jps.3030470133 · Cited by 2,491 · see citing works
Heat Stress and Public Health: A Critical Review
Kovats, S. R., & Hajat, S. (2007) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.29.020907.090843 · Cited by 1,921 · see citing works
Self-citationRelation between elevated ambient temperature and mortality: A review of the epidemiologic evidence
Basu, R. (2002) · Epidemiologic Reviews · doi:10.1093/epirev/mxf007 · Cited by 1,381 · see citing works
A new daily central England temperature series, 1772–1991
Parker, D. E., Legg, T. P., & Folland, C. K. (1992) · International Journal of Climatology · doi:10.1002/joc.3370120402 · Cited by 850 · see citing works
International study of temperature, heat and urban mortality: the “ISOTHURM” project
McMichael, A. J., Wilkinson, P., Kovats, R. S., Pattenden, S., Hajat, S., Armstrong, B., Vajanapoom, N., Niciu, E. M., Mahomed, H., Kingkeow, C., et al. (2008) · International Journal of Epidemiology · doi:10.1093/ije/dyn086 · Cited by 612 · see citing works
Self-citationThe effect of heat waves on mental health in a temperate Australian city
Hansen, A., Bi, P., Nitschke, M., Ryan, P., Pisaniello, D., & Tucker, G. (2008) · Environmental Health Perspectives · doi:10.1289/ehp.11339 · Cited by 569 · see citing works
Prognostic Factors in Heat Wave–Related Deaths<subtitle>A Meta-analysis</subtitle>
Bouchama, A. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.20.ira70009 · Cited by 565 · see citing works
Heat-related mortality during a 1999 heat wave in Chicago
Naughton, M. (2002) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(02)00421-x · Cited by 459 · see citing works
Vulnerability to Heat-Related Mortality
Stafoggia, M., Forastiere, F., Agostini, D., Biggeri, A., Bisanti, L., Cadum, E., Caranci, N., de'Donato, F. K., Lisio, S. D., Maria, M. D., et al. (2006) · Epidemiology · doi:10.1097/01.ede.0000208477.36665.34 · Cited by 440 · see citing works
Heat related mortality in warm and cold regions of Europe: observational study
Keatinge, W. R. (2000) · BMJ · doi:10.1136/bmj.321.7262.670 · Cited by 383 · see citing works
Rückerl, R., Greven, S., Ljungman, P. L. S., Aalto, P. P., Antoniades, C. A., Bellander, T., Berglind, N., Chrysohoou, C. A., Forastiere, F., Jacquemin, B., et al. (2007) · Environmental Health Perspectives · doi:10.1289/ehp.10021 · Cited by 315 · see citing works
Relationship between daily suicide counts and temperature in England and Wales
Page, L. A., Hajat, S., & Kovats, R. S. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.031948 · Cited by 245 · see citing works
Self-citationMantón, K. G. (2007) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.29.020907.090812 · Cited by 201 · see citing works
Association of mortality with high temperatures in a temperate climate: England and Wales
Armstrong, B., Chalabi, Z., Fenn, B., Hajat, S., Kovats, S. R., Milojevic, A., & Wilkinson, P. (2010) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2009.093161 · Cited by 197 · see citing works
Self-citationHeat-Related Death and Mental Illness During the 1999 Cincinnati Heat Wave
Kaiser, R., Rubin, C., Henderson, A. K., Wolfe, M. I., Kieszak, S. M., Parrott, C. L., & Adcock, M. P. (2001) · American Journal of Forensic Medicine & Pathology · doi:10.1097/00000433-200109000-00022 · Cited by 140 · see citing works
Ambient Temperature and Mortality From Unintentional Cocaine Overdose
Marzuk, P. M. (1998) · JAMA · doi:10.1001/jama.279.22.1795 · Cited by 136 · see citing works
The General Fertility Rate in Women With Psychotic Disorders
Howard, L. M., Kumar, C., Leese, M., & Thornicroft, G. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.6.991 · Cited by 124 · see citing works
Self-citationAssociation between daily environmental temperature and suicide mortality in Korea (2001–2005)
Kim, Y., Kim, H., & Kim, D. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.08.006 · Cited by 109 · see citing works
Do guidelines for severe mental illness promote physical health and well-being?
Citrome, L., & Yeomans, D. (2005) · Journal of Psychopharmacology · doi:10.1177/0269881105059505 · Cited by 103 · see citing works
Deaths of Psychiatric Patients During Heat Waves
Bark, N. M. (1998) · Psychiatric Services · doi:10.1176/ps.49.8.1088 · Cited by 99 · see citing works
The impact of climate change on mental health (but will mental health be discussed at Copenhagen?)
Page, L. A., & Howard, L. M. (2009) · Psychological Medicine · doi:10.1017/s0033291709992169 · Cited by 96 · see citing works
Self-citationKeatinge, W. R. (2003) · BMJ · doi:10.1136/bmj.327.7414.512 · Cited by 85 · see citing works
Likhvar, V., Honda, Y., & Ono, M. (2010) · Environmental Health and Preventive Medicine · doi:10.1007/s12199-010-0163-0 · Cited by 82 · see citing works
Mortality in southern England during the 2003 heat wave by place of death.
Kovats, S. R., Johnson, H., & Griffith, C. (2006) · PubMed · Cited by 81 · see citing works
Heat-Related Deaths in Philadelphia—1993
Mirchandani, H. G., McDonald, G., Hood, I. C., & Fonseca, C. (1996) · American Journal of Forensic Medicine & Pathology · doi:10.1097/00000433-199606000-00004 · Cited by 72 · see citing works
Psychotropic drugs, summer heat and humidity, and hyperpyrexia: a danger restated
Mann, S. C., & Boger, W. P. (1978) · American Journal of Psychiatry · doi:10.1176/ajp.135.9.1097 · Cited by 60 · see citing works
Nordon, C., Martin‐Latry, K., de Roquefeuil, L., Latry, P., Bégaud, B., Falissard, B., Rouillon, F., & Verdoux, H. (2009) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181b7ef6e · Cited by 51 · see citing works
Garland, A. F., Aarons, G. A., Brown, S. A., Wood, P. A., & Hough, R. L. (2003) · Psychiatric Services · doi:10.1176/appi.ps.54.4.562 · Cited by 48 · see citing works
Recurrent Heat-Related Illnesses During Antipsychotic Treatment
Kwok, J. S., & Chan, T. Y. (2005) · Annals of Pharmacotherapy · doi:10.1345/aph.1g130 · Cited by 45 · see citing works
Chapter 7 Pathophysiology of opioids in hyperthermic states
Romanovsky, A. A., & Blatteis, C. M. (1998) · Progress in brain research · doi:10.1016/s0079-6123(08)62032-4 · Cited by 8 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- [4]4. Bouchama A, Dehbi M, Mohamed G, Matthies F, Shoukri M, Menne B. Prognostic factors in heatwave-related deaths. A meta-analysis. Arch Intern Med 2007; 167: 2170-5.
- [17]17. Bark N. Deaths of psychiatric patients during heatwaves. Psychiatr Serv 1998; 49: 1088-90.
- [21]21. Keatinge W. Death in heatwaves. BMJ 2003; 327: 512-3.
- [26]26. Romanovsky AA, Blatteis CM. Pathophysiology of opioids in hyperthermic states. Prog Brain Res 1998; 115: 111-27.
Cited by
Sorted by citations
Climate change and mental health: risks, impacts and priority actions
Hayes, K., Blashki, G., Wiseman, J., Burke, S., & Reifels, L. (2018) · International Journal of Mental Health Systems · doi:10.1186/s13033-018-0210-6 · Cited by 746 · 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
Self-citationClimate Change and Mental Health: A Scoping Review
Charlson, F., Ali, S., Benmarhnia, T., Pearl, M., Massazza, A., Augustinavicius, J., & Scott, J. G. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094486 · Cited by 507 · see citing works
Lawrance, E. L., Thompson, R., Newberry Le Vay, J., Page, L., & Jennings, N. (2022) · International Review of Psychiatry · doi:10.1080/09540261.2022.2128725 · Cited by 500 · see citing works
Self-citationLiu, J., Varghese, B. M., Hansen, A., Xiang, J., Zhang, Y., Dear, K., Gourley, M., Driscoll, T., Morgan, G., Capon, A., et al. (2021) · Environment International · doi:10.1016/j.envint.2021.106533 · Cited by 406 · see citing works
Climate Change and Mental Health
Clayton, S. (2021) · Current Environmental Health Reports · doi:10.1007/s40572-020-00303-3 · Cited by 251 · see citing works
Wang, X., Lavigne, E., Ouellette-kuntz, H., & Chen, B. E. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.10.042 · Cited by 215 · see citing works
Basu, R., Gavin, L., Pearson, D., Ebisu, K., & Malig, B. (2018) · American Journal of Epidemiology · doi:10.1093/aje/kwx295 · Cited by 195 · see citing works
Zanobetti, A., O’Neill, M. S., Gronlund, C. J., & Schwartz, J. D. (2013) · Epidemiology · doi:10.1097/01.ede.0000434432.06765.91 · Cited by 201 · see citing works
Are workers at risk of occupational injuries due to heat exposure? A comprehensive literature review
Varghese, B. M., Hansen, A., Bi, P., & Pisaniello, D. (2018) · Safety Science · doi:10.1016/j.ssci.2018.04.027 · Cited by 198 · see citing works
Hayes, K., & Poland, B. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15091806 · Cited by 173 · 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
Peng, Z., Wang, Q., Kan, H., Chen, R., & Wang, W. (2017) · Science of The Total Environment · doi:10.1016/j.scitotenv.2017.02.237 · Cited by 127 · see citing works
Chan, E., Lam, H., So, S., Goggins, W., Ho, J., Liu, S., & Chung, P. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15040754 · Cited by 107 · see citing works
Climate change and disorders of the nervous system
Sisodiya, S. M., Gulcebi, M. I., Fortunato, F., Mills, J. D., Haynes, E., Bramon, E., Chadwick, P., Ciccarelli, O., David, A. S., De Meyer, K., et al. (2024) · The Lancet Neurology · doi:10.1016/s1474-4422(24)00087-5 · Cited by 105 · see citing works
Global priorities for climate change and mental health research
Charlson, F., Ali, S., Augustinavicius, J., Benmarhnia, T., Birch, S., Clayton, S., Fielding, K., Jones, L., Juma, D., Snider, L., et al. (2022) · Environment International · doi:10.1016/j.envint.2021.106984 · Cited by 103 · see citing works
“The unequal distribution of the mental health impacts of climate change has been explored among people with pre-existing mental health disorders (Jones et al., 2012; Page et al., 2012; Trang et al., 2016), Indigenous populations (Rigby et al.”
BackgroundThe clinical implications of climate change for mental health
Crandon, T. J., Dey, C., Scott, J. G., Thomas, H. J., Ali, S., & Charlson, F. J. (2022) · Nature Human Behaviour · doi:10.1038/s41562-022-01477-6 · Cited by 88 · see citing works
Sarofim, M. C., Saha, S., Hawkins, M. D., Mills, D. M., Hess, J., Horton, R., Kinney, P., Schwartz, J., & St. Juliana, A. (2016) · doi:10.7930/j0mg7mdx · Cited by 88 · see citing works
Policy brief on climate change and mental health/well-being
Liu, J., Potter, T., & Zahner, S. (2020) · Nursing Outlook · doi:10.1016/j.outlook.2020.06.003 · Cited by 44 · see citing works
Climate “Psychopathology”: The Intersection of Mental and Physical Health in the Climate Emergency
Thompson, H. E. (2021) · European Psychologist · doi:10.1027/1016-9040/a000433 · Cited by 15 · see citing works
- Authors
- Page, L. A., Hajat, S., Kovats, R. S., & Howard, L. M.
- Affiliations
- Sussex Partnership NHS Foundation Trust (GB)
- London School of Hygiene & Tropical Medicine (GB)
- King's College London (GB)
- Corresponding author
- Page, Lisa A.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2012-06
- Volume
- 200
- Issue
- 6
- Pages
- 485-490
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2110506480
- Cited by
- 193
- References
- 32
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 32 · 2023: 16 · 2022: 23 · 2021: 19 · 2020: 14 · 2019: 12 · 2018: 11 · 2017: 12 · 2016: 6 · 2015: 6 · 2014: 3 · 2013: 8 · 2012: 2
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- South London and Maudsley NHS Foundation Trust
- Wellcome Trust
- National Institute for Health and Care Research
- Bupa Foundation
- King's College London
- Medical Research Council
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Effects of Environmental Stressors on Livestock
- Keywords
- temperature-related mortality, heat waves, psychosis, dementia, substance abuse, mental illness, climate change, ambient temperature, primary care patients, youth
- MeSH terms
- Adult, Aged, Dementia, England, Hot Temperature, Humans, Middle Aged, Psychotic Disorders, Residence Characteristics, Risk Factors, Seasons, Cohort Studies, Substance-Related Disorders, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
