What Should You Expect as a Psychiatrist?
Dr. Kiranmai Yarlagadda, M.D, Johnston, Iowa
Dr. Jess Fiedorowicz, M.D, Ph.D , Iowa City, Iowa
Dr. Tolga Taneli, M.D, Newark, New Jersey
The impact of seasonal changes on behavior has been a topic of popular interest and of interest to psychiatry. Some of these problems like depression occur more often and may be more severe during winter months and are more likely to improve during the summer. Does this mean we can expect our patients to experience fewer difficulties? Well, that might depend on the nature of the complaint.
During summer, certain mental health issues need more attention than usual. For children, teens and students, there is less structure in the summer relative to the rest of the year resulting in behavioral changes1. Aggressive and oppositional behaviors may be more likely in children and adolescents during such times2. Several studies have shown an effect of weather on violence in developed and developing countries. An increase in ambient temperatures and humidity related to the seasonal changes may increase aggressive behavior in human beings through three proposed routes: hostile affect, hostile cognition and physiological arousal3.We sought evidence of similar summer increases in violent behaviors locally.
An analysis of publicly available crime statistics from Des Moines, Iowa showed that an increase in ambient temperature and humidity can indeed increase in frequency of violent crime. Frequency of aggravated assault was analyzed against maximum and mean ambient temperature for the three urban ZIP-codes (50309, 50310 and 50311), using crime data for July 2005 to October 2011 (2313 days) obtained from Des Moines Police Department. There was a linear increase in number of aggravated assaults per day (see graph) and the percentage of related crime days steadily increased across maximum temperature quartiles (26.4%, 30.0%, 37.0% and 39.1% from lowest to highest maximum temperature quartile respectively with p<0.01)4. There was a similar linear increase with mean temperature quartiles (p<0.01) where the percentage of aggravated assaults differed by quartile though not in the same linear pattern 4. The lowest humidity quartile had only 12.0% of aggravated assault crime days compared to 36.3%, 33.7%, and 37.5% for each increasing quartile (c2=9.4, df=3, p=.025)4. This analysis of local data generally in line with aforementioned data suggests that we may indeed expect more aggressive or violent behaviors in the season ahead.
Figure 1 4:
The utility of this information may extend beyond law enforcement preparedness. With daily temperatures soon to be rising this summer, in addition to keeping general psychiatric issues in mind, it is also important for the psychiatrists to be prepared for any aggressive tendencies in their patients that can trigger violence. While behavioral problems arising from unstructured summer can be addressed by parents through talking to their children about shared goals during summer and providing some structure, it is also helpful to encourage them be active, limit the time spent with electronic devices, encourage regular exercise, maintain adequate sleep, and continue to regularly take their medicines, if applicable1. In heeding the risk associated with changes in temperature and routine, we hope you are prepared for the season ahead, whatever it may bring.
1. Weaver, R. (2012). Dealing with Mental Health Issues During the Summer. http://www.goodtherapy.org/blog/mental-health-summer-depression-adhd-0430125/
2. Peterson, BS., Zhang, H., Santa Lucia, R., King, RA., Lewis, M. (1996). Risk factors for presenting problems in child psychiatric emergencies. J Am Acad Child Adolesc Psychiatry, 35(9), 1162-73
3. Anderson, C. A., Deuser, W, E., DeNeve, K, M. (1995). Hot Temperatures, Hostile Affect, Hostile Cognition, and Arousal: Tests of a General Model of Affective Aggression. Society for Personality and Social Psychology, Inc., 21(5), 434-448.
4. Janusz, C., Yarlagadda, K., Ndukwe, N., Radhakrishnan, A., Ciccone, D., Taneli, T. (2012). Ambient Temperature and Humidity Influence Criminal Behavior. 64thInstitute on Psychiatric Services. Annual meeting, Poster (PS6-20).