ABSTRACT
Objective: To analyze emergency department (ED) mental health presentations over a 7-year period to estimate the timing and magnitude of the seasonal effect across Australia.
Methods: We analyzed data collected by the Australian Institute of Health and Welfare (AIHW) from 2014–2015 to 2020–2021, which included all public hospital ED presentations in Australia that received a mental health diagnosis per the Australian Modification of ICD-10. The data were divided into 4 sequential quarters (Q1 = July–September, Q2 = October–December, Q3 = January–March, Q4 = April–June) and analyzed by sex and age (youth: 18–24 years, adult: 25–64 years, and older adult: > 65 years). Regression analysis was used to assess seasonal variation.
Results: On average, mental health ED presentations were 9% higher in October–December than April–June, which had the lowest rates of mental health ED presentations for males and females. The peak continued into January–March, most prominently for females. Seasonality was evident in the 18–24 and 25–64 age groups. There were increased ED psychiatry presentations in October–December of 14.4% (males) and 9% (females) in the group aged 18–24, as well as increases of 10.3% (males) and 10.1% (females) in those aged 25–64. In January–March, there was an increase in presentations for females of 7% (aged 18–24) and 10.3% (aged 25–64). For adults aged > 65, there were increased presentations in July–September compared to April–June of 4.9% (males) and 3.9% (females).
Conclusions: We found strong, statistically significant peaks in mental health ED presentations in spring and summer. Mental health services need to plan for significantly higher ED mental health demand during these seasons. Further research is required to estimate the size of the mental health seasonal effect in acute hospital settings.
Prim Care Companion CNS Disord 2024;26(1):23m03629
Author affiliations are listed at the end of this article.
Free Access: Please Log In
This content is completely free—but you need to be logged in to read the full article. If you already have an account, please log in below. Otherwise, register for free to unlock instant access.
References (37)
- Burnett FH. The Secret Garden. Heinemann; 2011.
- Della DF, Allison S, Bidargaddi N, et al. An umbrella systematic review of seasonality in mood disorders and suicide risk: the impact on demand for primary behavioral health care and acute psychiatric services. Prim Care Companion CNS Disord. 2023;25(3):47217. PubMed CrossRef
- Boulay F, Berthier F, Sisteron O, et al. Seasonal variation in chronic heart failure hospitalizations and mortality in France. Circulation. 1999;100(3):280–286. PubMed CrossRef
- Akintoye E, Briasoulis A, Egbe A, et al. Seasonal variation in hospitalization outcomes in patients admitted for heart failure in the United States. Clin Cardiol. 2017;40(11):1105–1111. PubMed CrossRef
- Moriyama M, Hugentobler WJ, Iwasaki A. Seasonality of respiratory viral infections. Annu Rev Virol. 2020;7(1):83–101. PubMed CrossRef
- Hamedani AG, Thibault D, Willis AW. Seasonal variation in neurologic hospitalizations in the United States. Ann Neurol. 2023;93(4):743–751. PubMed CrossRef
- Rollnik JD, Dimsdale JE, Ng B. Variation of psychiatric emergencies across seasons in San Diego County. Depress Anxiety. 2000;11(1):48–49. PubMed CrossRef
- Heboyan V, Stevens S, McCall WV. Effects of seasonality and daylight savings time on emergency department visits for mental health disorders. Am J Emerg Med. 2019;37(8):1476–1481. PubMed CrossRef
- Zeppegno P, Gramaglia C, Castello LM, et al. Suicide attempts and emergency room psychiatric consultation. BMC Psychiatry. 2015;15(1):13. PubMed CrossRef
- Coimbra DG, Pereira E Silva AC, de Sousa-Rodrigues CF, et al. Do suicide attempts occur more frequently in the spring too? a systematic review and rhythmic analysis. J Affect Disord. 2016;196:125–137. PubMed CrossRef
- Rogers B, Legaspi JP, Bastiampillai T. Hospital congestion: a market solution to address delayed transfers of care from hospital beds. Med J Aust. 2023;218(7):298–300. PubMed CrossRef
- Australian Institute of Health and Welfare. Emergency department mental health services. Canberra: AIHW;2022. Accessed July 1, 2023. https://www.aihw.gov.au/mental-health/topic-areas/emergency-departments
- Moore BJ, Stocks C, Owens PL. Trends in emergency department visits, 2006-2014. The HCUP report: Healthcare cost and utilization project (HCUP): Statistical briefs #227. September 2017. Accessed June 6, 2023. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb227-Emergency-Department-Visit-Trends.jsp
- Øverland S, Woicik W, Sikora L, et al. Seasonality and symptoms of depression: a systematic review of the literature. Epidemiol Psychiatr Sci. 2020; 29:e31. PubMed CrossRef
- Zhang R, Volkow ND. Seasonality of brain function: role in psychiatric disorders. Transl Psychiatry. 2023;13(1):65. PubMed CrossRef
- Nevarez-Flores AG, Bostock ECS, Neil AL. Should clinicians and the general population be concerned about seasonal affective disorder in Australia? BMC Psychiatry. 2021;21:317.
- Nevarez-Flores AG, Bostock ECS, Neil AL. The underexplored presence of seasonal affective disorder in the southern hemisphere: a narrative review of the Australian literature. J Psychiatry Res. 2023;162:170–179. PubMed CrossRef
- Gonzalez R. The relationship between bipolar disorder and biological rhythms. J Clin Psychiatry. 2014;75(4):e323–e331. PubMed CrossRef
- Durkheim E. Suicide: A Study in Sociology. New York, New York: Free Press; 1951.
- Yu J, Yang D, Kim Y, et al. Seasonality of suicide: a multi-country multi-community observational study. Epidemiol Psychiatr Sci. 2020;29:e163. PubMed CrossRef
- Woo J-M, Okusaga O, Postolache TT. Seasonality of suicidal behavior. Int J Environ Res Public Health. 2012;9(2):531–547. PubMed CrossRef
- Koskinen O, Pukkila K, Hakko H, et al. Is occupation relevant in suicide? J Affect Disord. 2002;70(2):197–203. PubMed CrossRef
- Australian Food News. Australian seasonal drinking habits as distilled by Roy Morgan Research. September 2015. Accessed June 1, 2023. https://www.ausfoodnews.com.au/2015/09/07/australian-seasonal-drinking-habits-as-distilled-by-roy-morgan-research.html
- Chong DG, Buckley NA, Schumann JL, et al. Acute alcohol use in Australian coronial suicide cases, 2010–2015. Drug Alcohol Depend. 2020;212:108066. PubMed CrossRef
- Lemmens PH, Knibbe RA. Seasonal variation in survey and sales estimates of alcohol consumption. J Stud Alcohol. 1993;54(2):157–163. PubMed CrossRef
- Knudsen AK, Skogen JC. Monthly variations in self-report of time-specified and typical alcohol use: the Nord-Trøndelag Health Study (HUNT3). BMC Public Health. 2015;15(1):172. PubMed CrossRef
- Foster S, Gmel G, Estévez N, et al. Temporal patterns of alcohol consumption and alcohol-related road accidents in young Swiss men: seasonal, weekday and public holiday effects. Alcohol Alcohol. 2015;50(5):565–572. PubMed CrossRef
- Ontario Public Health Association. Seasonal Trends in Alcohol Consumption. July 2016. Accessed June 1, 2023. https://opha.on.ca/seasonal-trends-in-alcohol-consumption/
- Sohal A, Bains K, Dhaliwal A, et al. Seasonal variations of hospital admissions for alcohol-related hepatitis in the United States. Gastroenterol Res. 2022;15(2):75–81. PubMed CrossRef
- Roberts SE, Akbari A, Thorne K, et al. The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther. 2013;38(5):539–548. PubMed CrossRef
- Palamar JJ, Rutherford C, Keyes KM. Summer as a risk factor for drug initiation. J Gen Intern Med. 2020;35(3):947–949. PubMed CrossRef
- Australian Criminal Intelligence Commission. ‘National Wastewater Drug Monitoring Program–Report 15. March 2022. Accessed June 1, 2023. https://www.acic.gov.au/sites/default/files/2022-03/National%20Wastewater%20Drug%20Monitoring%20Program%20Report%2015%20%28v13_FINAL%20no%20UE%29.PDF
- Werschler T, Brennan A. Statistics Canada. Analysis in Brief: Wastewater-based Estimates of Cannabis and Drug Use in Canada: Pilot test Detailed Results. August 2019. Accessed 1 June 2023. https://www150.statcan.gc.ca/n1/pub/11-621-m/11-621-m2019004-eng.htm
- Souêtre E, Salvati E, Belugou JL, et al. Seasonality of suicides: environmental, sociological and biological covariations. J Affect Disord. 1987;13(3):215–225. PubMed CrossRef
- Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia. Canberra: AIHW;2023. Accessed July 25, 2023. https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/priority-populations/older-people
- Nöbbelin L, Bogren M, Mattisson C, et al. Incidence of melancholic depression by age of onset and gender in the Lundby population, 1947-1997. Eur Arch Psychiatry Clin Neurosci. 2023;273(5):1163–1173. PubMed CrossRef
- Parker G, Hyett MP, Friend P, et al. Does age impact on rating melancholic and non-melancholic depressive symptoms? J Affect Disord. 2013;147(1-3):318–324. PubMed CrossRef
Please sign in or purchase this PDF for $40.