International Journal of Biometeorology

, Volume 62, Issue 5, pp 843–850 | Cite as

Weather conditions influence the number of psychiatric emergency room patients

  • Eva Janina Brandl
  • Tristram A. Lett
  • George Bakanidze
  • Andreas Heinz
  • Felix Bermpohl
  • Meryam Schouler-Ocak
Original Paper


The specific impact of weather factors on psychiatric disorders has been investigated only in few studies with inconsistent results. We hypothesized that meteorological conditions influence the number of cases presenting in a psychiatric emergency room as a measure of mental health conditions. We analyzed the number of patients consulting the emergency room (ER) of a psychiatric hospital in Berlin, Germany, between January 1, 2008, and December 31, 2014. A total of N = 22,672 cases were treated in the ER over the study period. Meteorological data were obtained from a publicly available data base. Due to collinearity among the meteorological variables, we performed a principal component (PC) analysis. Association of PCs with the daily number of patients was analyzed with autoregressive integrated moving average model. Delayed effects were investigated using Granger causal modeling. Daily number of patients in the ER was significantly higher in spring and summer compared to fall and winter (p < 0.001). Three PCs explained 76.8% percent of the variance with PC1 loading mostly on temperature, PC2 on cloudiness and low pressure, and PC3 on windiness. PC1 and PC2 showed strong association with number of patients in the emergency room (p < 0.010) indicating higher patient numbers on warmer and on cloudy days. Further, PC1, PC2, and PC3 predicted the number of patients presenting in the emergency room for up to 7 days (p < 0.050). A secondary analysis revealed that the effect of temperature on number of patients was mostly due to lower patient numbers on cold days. Although replication of our findings is required, our results suggest that weather influences the number of psychiatric patients consulting the emergency room. In particular, our data indicate lower patient numbers during very cold temperatures.


Psychiatric emergencies Climate Factor analysis Autoregressive integrated moving average model Granger causal modeling 



EJB is participant in the BIH Charité Clinician Scientist Program funded by Charité Universitätsmedizin Berlin and the Berlin Institute of Health. TAL is recipient of a Canadian Institutes of Health Research Postdoctoral Fellowship.

Compliance with ethical standards

The study was approved by the local ethics board and has been conducted in accordance with the declaration of Helsinki. For this type of retrospective study, obtaining consent was not required.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© ISB 2017

Authors and Affiliations

  • Eva Janina Brandl
    • 1
    • 2
  • Tristram A. Lett
    • 3
  • George Bakanidze
    • 1
  • Andreas Heinz
    • 1
    • 3
  • Felix Bermpohl
    • 1
  • Meryam Schouler-Ocak
    • 1
  1. 1.Psychiatric University Hospital of Charité at St. Hedwig-HospitalBerlinGermany
  2. 2.Berlin Institute of HealthBerlinGermany
  3. 3.Department of Psychiatry and PsychotherapyCharité Universitätsmedizin Berlin, Campus MitteBerlinGermany

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