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Health See other Health Articles Title: Mortality in Mentally Ill Rises With Soaring Temperatures June 6, 2012 — Patients with psychosis, dementia, or substance misuse may be at an increased mortality risk during hot weather, new research suggests. A cohort study of adult patients in England showed that for those with severe mental illness, the risk for death increased by almost 5% per 1° C increase in temperature above 18° C. In contrast, the risk for the general population is approximately 2% per 1° C increase. The greatest mortality risk found in this study was for those who were younger than 65 years, those specifically diagnosed with drug or alcohol misuse, and those taking antipsychotics. "This suggests that people with mental illness may be a vulnerable group," lead author Lisa A. Page, PhD, MRCPsych, from the Mental Health Liaison Team at the Royal Sussex County Hospital and from the Sussex Partnership National Health Service Foundation Trust, United Kingdom (UK), said in a release. "Some public health strategies, such as the English 'Heatwave Plan,' already identify patients with mental health problems as being a high-risk group. But more attention may need to be paid to patients with alcohol and drug misuse problems, who are often not under the care of mental health services," said Dr. Page. The investigators note that their finding that the mortality risk was increased for younger patients was surprising but may be explained by the fact that many of their elderly participants had dementia. "It may be that their care was better," they write. The study is published in the June issue of the British Journal of Psychiatry. Social Isolation The researchers examined records from the UK General Practice Research Database, which includes information on 4 million primary care patients. A total of 22,562 patients were identified who had a primary diagnosis of psychosis, alcohol or drug misuse, or dementia and had died in England between 1998 and 2007. Information on daily temperatures during that period was assessed from the British Atmospheric Data Center. Results showed that the overall patient group had an increase in the relative risk for death when temperatures were higher than the heat threshold of 18°C. In addition, the patients had an increased risk for death of 4.9% (95% confidence interval, 2.0 - 7.8) per 1° C increase in temperature above the heat threshold. The investigators note that individuals with mental disorders are often socially isolated or living in institutional care. Both of these are considered risk factors for heat-related death. Those who were younger than 65 years were also at higher risk for death compared with those older than 65 years (10% vs 4% per 1° C above the heat threshold). Dysregulation of Body Temperature "Hypnotic/anxiolytic and antipsychotic medications were associated with elevated risk during hot weather (8% and 7% increase...respectively), while antidepressant medication was not," report the researchers. This could be because antipsychotics can affect the ability to regulate body temperature by reducing sweating. The investigators also note that patients with substance misuse problems may be vulnerable because alcohol depresses the central nervous system, which causes dehydration, and opiates can affect the body's physiological response to heat. "The strikingly elevated risk of death we observed among patients with substance misuse has not previously been noted and has potential implications for public health strategies," they write. "Given that global temperatures will continue to rise and the frequency of heat waves is predicted to increase in the years to come, these findings suggest that the consequences of climate change may be felt disproportionately by the mentally ill," senior researcher Louise M. Howard, PhD, MRCPsych, professor at the Institute of Psychiatry at King's College London, concluded in the release. The study was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre and by grants from the Wellcome Trust and the UK Medical Research Council. The study authors have disclosed no relevant financial relationships. Br J Psychiatry. 2012;200:485-490. Abstract Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest
#1. To: Tatarewicz (#0)
(Edited)
Plenty of reasons are possible, and in fact may combine to cause the phenomenon. It's true that their medication may have made them more sensitive to heat; the same may apply to "self-medicating" with booze or illicit drugs. Some of these mentally ill may already have overly high body temps, it is possible that some of them are feverish. It is possible that their illness, or their inability to get along with other people, causes them to leave (or be asked to leave) air conditioned buildings and be outside in the sun and the heat; the same could also separate them from sufficient cool water (or any water). Their overall condition, including the mental illness and any disorientation or desensitization from their medication/booze/drugs makes them unaware or unable to respond properly when the symptoms of heat stroke begin to manifest. Lots of possible reasons. And many of these reasons could make the same people more susceptible to hypothermia/exposure in the dead of winter.
Now we know why yukon moved to Alaska.
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