Hot weather increases death risk in psychosis patients

By Mark Cowen

Hot weather is associated with increased mortality rates among patients with psychosis, dementia, or substance use disorder, UK research shows.

"It is likely that the multiple physical comorbidities experienced by people with mental illness substantially contribute to their vulnerability during hot weather," comment Lisa Page (Royal Sussex County Hospital, Brighton) and team.

"Optimising physical care for these patients has become a clinical priority and general improvements to their physical health could reduce their risk of heat-related mortality," they add.

The researchers used the General Practice Research Database to identify 22,562 people with a primary diagnosis of psychosis, dementia, or substance misuse who died in England between 1998 and 2007.

Daily temperature data for the study period were collected from British Atmospheric Data Centre, and compared with short-term mortality rates among the study population.

The team found each 1°C increase in temperature above the 93rd percentile of the annual temperature distribution (approximately 18°C on average) was associated with a 4.9% increased risk for death among people with mental illnesses.

This increased risk was greater among younger than older age groups. Indeed, each 1°C increase in temperature above the 93rd percentile was associated with a 10% increased risk death among patients aged less than 65 years, compared with a 4% increased risk among those aged 65 years and older.

Furthermore, patients with a primary diagnosis of substance misuse were at greater risk for death in hot weather compared with other patients, as were those taking hypnotic/anxiolytic and antipsychotic medications.

Writing in the British Journal of Psychiatry, Page et al conclude: "Given that global temperatures will continue to rise and the frequency of heatwaves is predicted to increase in the years to come, these findings suggest that consequences of climate change may be felt disproportionately by people with mental illness."

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