Real-World Evidence for the Association between Heat-Related Illness and the Risk of Psychiatric Disorders in Taiwan

Fang-Ling Li; Wu-Chien Chien; Chi-Hsiang Chung; Chung-Yu Lai; Nian-Sheng Tzeng

doi:10.3390/ijerph19138087

Real-World Evidence for the Association between Heat-Related Illness and the Risk of Psychiatric Disorders in Taiwan

Int J Environ Res Public Health. 2022 Jul 1;19(13):8087. doi: 10.3390/ijerph19138087.

Authors

Fang-Ling Li^{1

2}, Wu-Chien Chien^{3

4

5

6}, Chi-Hsiang Chung^{3

4

6}, Chung-Yu Lai⁷, Nian-Sheng Tzeng^{2

8}

Affiliations

¹ Department of Psychiatry, Tri-Service General Hospital Beitou Branch, National Defense Medical Center, Taipei City 112, Taiwan.
² Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei City 114, Taiwan.
³ Department of Medical Research, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City 114, Taiwan.
⁴ School of Public Health, National Defense Medical Center, Taipei City 114, Taiwan.
⁵ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City 114, Taiwan.
⁶ Taiwanese Injury Prevention and Safety Promotion Association, Taipei City 114, Taiwan.
⁷ Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei City 114, Taiwan.
⁸ Student Counseling Center, National Defense Medical Center, Taipei City 114, Taiwan.

Abstract

This study aimed to investigate the association between the heat-related illness (HRI) and the risk of developing psychiatric disorders. From 2000 to 2015, there were 3126 patients with newly diagnosed HRI selected from the National Health Insurance Research Database, along with 31,260 controls matched for gender and age. Fine and Gray’s analysis was used to compare the risk of psychiatric disorders during the 16 years of follow-up. Among the subjects, 523 of the HRI patients and 3619 of the control group (1774.18 vs. 1193.78 per 100,000 person-years) developed psychiatric disorders. Compared with non-HRI patients, the HRI ones had a 3.849-fold risk of being attacked by psychiatric disorders (95% CI: 3.632−4.369, p < 0.001) after adjusting for potential confounders. The sensitivity analysis revealed that the relationship between the HRI and the listed psychiatric disorders was determined by the exclusion of the first-year psychiatric events after the HRI. In spite of deleting the psychiatric diagnoses of the first five years, the HRI was still correlated with the development of psychiatric disorders with the exception of schizophreniform disorders, posttraumatic stress disorders, and acute stress disorder. Therefore, our findings concluded that the HRI could be a potential influence on the increased hazard of psychiatric disorders.

Keywords: National Health Insurance Research Database; heat-related illness; psychiatric disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Databases, Factual
Heat Stress Disorders* / epidemiology
Hot Temperature
Humans
Mental Disorders* / epidemiology
Risk Factors
Taiwan / epidemiology

Grants and funding

We appreciated the financial support from the Medical Affairs Bureau, Ministry of National Defense (MND-MAB-110-087, MND-MAB-D-111075), the Tri-Service General Hospital (TSGH-E-110240), and the Taoyuan Armed Forces General Hospital (TYAFGH-A-110020) in Taiwan.