Association between ambient temperature and emergency psychiatric consultations: A case-crossover study in a South American emergency setting (2021–2023)

Article

Torales, J., Laterza, M., Persaud, A., O’Higgins, M., Torres-Romero, A. D., Caycho-Rodríguez, T., Ventriglio, A., Castaldelli-Maia, J. M., El-Khoury, J., Chumakov, E., Liebrenz, M., Smith, A., Tribe, R., Javed, A., Bhugra, D. and Barrios, I. 2025. Association between ambient temperature and emergency psychiatric consultations: A case-crossover study in a South American emergency setting (2021–2023). International Journal of Social Psychiatry. p. In press. https://doi.org/10.1177/00207640251336725
AuthorsTorales, J., Laterza, M., Persaud, A., O’Higgins, M., Torres-Romero, A. D., Caycho-Rodríguez, T., Ventriglio, A., Castaldelli-Maia, J. M., El-Khoury, J., Chumakov, E., Liebrenz, M., Smith, A., Tribe, R., Javed, A., Bhugra, D. and Barrios, I.
Abstract

Background:
Although environmental factors have been studied for their impact on mental health, the link between ambient temperature and mental disorders remains insufficiently explored.

Aim:
This study aimed to explore the relationship between ambient temperature and the frequency of emergency psychiatric consultations at the sole university hospital in Paraguay from 2021 to 2023.

Methods:
This investigation adopted a quantitative, observational, cross-sectional design, using a case-crossover approach. Data collection entailed reviewing patient records and meteorological data, focusing on the daily mean temperatures and other meteorological variables. Statistical analysis was conducted using RStudio and SPSS, applying a distributed lag non-linear model (DLNM) for a seven-day lag period. Multinomial logistic regression was used to estimate odds ratios (ORs) for the likelihood of specific diagnoses resulting in emergency consultations in relation to temperature exposure.

Results:
The analysis covered 2,186 first-time emergency psychiatric consultations, with anxiety disorders being the most frequent diagnosis (24.3%), followed by depressive disorders (23.4%) and personality disorders (15.8%). Women accounted for 70.6% of all patients. The findings indicated that higher temperatures were associated with a greater frequency of consultations for certain disorders, including bipolar (OR up to 27.12 at Lag 1) and eating disorders (OR up to 100 at Lag 1). Conversely, a negative association was observed for schizophrenia, dissociative disorders, and trauma- and stressor-related disorders as temperature increased. Additionally, a linear relationship was found between lower relative humidity and increased number of consultations.

Conclusions:
The findings underscore the impact of ambient temperature on psychiatric emergency consultations, revealing that the frequency of consultations for different conditions varies with temperature. These insights could inform public health strategies to mitigate the effects of climatic variation on mental health. These findings suggest the need for targeted mental health interventions to address vulnerabilities during periods of climatic stress, particularly in resource-limited settings.

JournalInternational Journal of Social Psychiatry
Journal citationp. In press
ISSN0020-7640
1741-2854
Year2025
PublisherSAGE
Accepted author manuscript
License
File Access Level
Anyone
Digital Object Identifier (DOI)https://doi.org/10.1177/00207640251336725
Publication dates
Online06 May 2025
Publication process dates
Accepted06 May 2025
Deposited13 May 2025
Copyright holder© 2025 The Authors
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Tunariu, A., Tribe, R., Frings, D. J. and Albery, I. P. 2017. The iNEAR programme: an existential positive psychology intervention for resilience and emotional wellbeing. International Review of Psychiatry. 29 (4), pp. 362-372. https://doi.org/10.1080/09540261.2017.1343531
Turning your dissertation into a publishable journal article
Tribe, R. and Tunariu, A. 2017. Turning your dissertation into a publishable journal article. The Psychology of Education Review. 41 (2), pp. 22-30.
Preparing for and writing up your doctoral thesis
Tribe, R. and Tunariu, A. 2017. Preparing for and writing up your doctoral thesis. The Psychology of Education Review. 41 (2), pp. 4-13.
A brief guide to ageing and food
Lane, Pauline and Tribe, R. 2017. A brief guide to ageing and food. in: Lane, Pauline and Tribe, R. (ed.) Anti-discriminatory Practice in Mental Health Care for Older People Jessica Kingsley.
Preparing for and writing up your doctoral thesis
Tribe, R. and Tunariu, A. 2017. Preparing for and writing up your doctoral thesis. Counselling Psychology Review. 32 (2), pp. 57-66.
How do daughters experience having a mother with dementia?
Finill, C. and Tribe, R. 2017. How do daughters experience having a mother with dementia? Counselling Psychology Review. 32 (2), pp. 4-13.
Social Justice, Diversity and Leadership
Tribe, R. and Bell, D. 2017. Social Justice, Diversity and Leadership. European Journal of Counselling Psychology. 6 (1), pp. 111-125. https://doi.org/10.5964/ejcop.v6i1.145
Turning your dissertation into a publishable journal article
Tribe, R. and Tunariu, A. 2016. Turning your dissertation into a publishable journal article. Counselling Psychology Review. 31 (1), pp. 50-58.
Preparing for a doctoral viva
Tribe, R. and Tunariu, A. 2016. Preparing for a doctoral viva. Counselling Psychology Review. 31 (1), pp. 59-66.
Interpreting in mental health, roles and dynamics in practice
Resera, Elena, Tribe, R. and Lane, Pauline 2015. Interpreting in mental health, roles and dynamics in practice. International Journal of Culture and Mental Health. 8 (2), pp. 192-206.
Mind your language: working with interpreters in healthcare settings and therapeutic encounters
Tribe, R. and Tunariu, A. 2009. Mind your language: working with interpreters in healthcare settings and therapeutic encounters. Sexual and Relationship Therapy. 24 (1), pp. 74-84.
Following NICE 2008: a practical guide for health professionals on community engagement with local black and minority ethnic (BME) community groups
Lane, Pauline and Tribe, R. 2010. Following NICE 2008: a practical guide for health professionals on community engagement with local black and minority ethnic (BME) community groups. Diversity in Health and Care. 7 (2), pp. 105-114.
Increasing mental health capacity in a post-conflict country through effective professional volunteer partnerships: A series of case studies with government agencies, local NGOs and the diaspora community
Tribe, R., Weerasinghe, Dilanthi and Parameswaran, Shanthy 2014. Increasing mental health capacity in a post-conflict country through effective professional volunteer partnerships: A series of case studies with government agencies, local NGOs and the diaspora community. International Review of Psychiatry. 26 (5), pp. 558-565.
Globalization, culture and mental health [Editorial]
Tribe, R. and Melluish, Steve 2014. Globalization, culture and mental health [Editorial]. International Review of Psychiatry. 26 (5), pp. 535-537.
Culture, Politics and Global Mental Health
Tribe, R. 2014. Culture, Politics and Global Mental Health. Disability and the Global South. 1 (2), pp. 251-265.
A Critical Review of the Evolution of a Multi-level Community-based Children's Play Activity Programme Run by the Family Rehabilitation Centre (FRC) Throughout Sri Lanka
Tribe, R. 2004. A Critical Review of the Evolution of a Multi-level Community-based Children's Play Activity Programme Run by the Family Rehabilitation Centre (FRC) Throughout Sri Lanka. Journal of Refugee Studies. 17 (1), pp. 114-135.
Exploring Polish migrants' adaptation to life in the UK: an interpretative phenomenological analysis
O'Brien, Paul and Tribe, R. 2013. Exploring Polish migrants' adaptation to life in the UK: an interpretative phenomenological analysis. International Journal of Culture and Mental Health. 7 (4), pp. 439-451.
WPA guidance on mental health and mental health care in migrants
Bhugra, D., Gupta, S., Bhui, K., Craig, T., Dogra, N., Ingleby, J.D., Kirkbride, J., Moussaoui, D., Nazroo, J., Qureshi, A., Stompe, T. and Tribe, R. 2011. WPA guidance on mental health and mental health care in migrants. World Psychiatry. 10 (1), pp. 2-10.
Opportunity for development or necessary nuisance? The case for viewing working with interpreters as a bonus in therapeutic work
Tribe, R. and Thompson, Kate 2009. Opportunity for development or necessary nuisance? The case for viewing working with interpreters as a bonus in therapeutic work. International Journal of Migration, Health and Social Care. 5 (2), pp. 4-12.
Bridging the gap or damming the flow? Some observations on using interpreters/bicultural workers when working with refugee clients, many of whom have been tortured
Tribe, R. 1999. Bridging the gap or damming the flow? Some observations on using interpreters/bicultural workers when working with refugee clients, many of whom have been tortured. British Journal of Medical Psychology. 72 (4), pp. 567-576.
Mental health of refugees and asylum-seekers
Tribe, R. 2002. Mental health of refugees and asylum-seekers. Advances in Psychiatric Treatment. 8 (4), pp. 240-247.
Unequal care: an introduction to understanding UK policy and the impact on asylum-seeking children
Lane, Pauline and Tribe, R. 2006. Unequal care: an introduction to understanding UK policy and the impact on asylum-seeking children. International Journal of Migration, Health and Social Care. 2 (2), pp. 7-14.
Refugees and asylum seekers
Tribe, R. and Patel, N. 2007. Refugees and asylum seekers. The Psychologist. 20 (3), pp. 149-151.
Working with interpreters
Tribe, R. 2007. Working with interpreters. The Psychologist. 20 (3), pp. 159-161.
Exploring the Three-Way Relationship in Therapeutic Work with Interpreters
Tribe, R. and Thompson, Kate 2009. Exploring the Three-Way Relationship in Therapeutic Work with Interpreters. International Journal of Migration, Health and Social Care. 5 (2), pp. 13-21.
Working with Interpreters in Health Settings: Guidelines for Psychologists
Tribe, R., Thompson, Kate and British Psychological Society, Professional Practice Board 2008. Working with Interpreters in Health Settings: Guidelines for Psychologists. Leicester The British Psychological Society.
Health Pluralism: A More Appropriate Alternative to Western Models of Therapy in the Context of the Civil Conflict and Natural Disaster in Sri Lanka?
Tribe, R. 2007. Health Pluralism: A More Appropriate Alternative to Western Models of Therapy in the Context of the Civil Conflict and Natural Disaster in Sri Lanka? Journal of Refugee Studies. 20 (1), pp. 21-36. https://doi.org/10.1093/jrs/fel031
Good practice issues in working with interpreters in mental health
Tribe, R. and Morrissey, J. 2004. Good practice issues in working with interpreters in mental health. Intervention: Journal of Mental Health and Psychosocial Support in Conflict Affected Areas. 2 (2), pp. 129-142.