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Results: The data suggest that total numbers of acts of violence and
emergency psychiatry visits are significantly associated with low
barometric pressure. Psychiatric inpatient admissions and suicides
are not associated with any of the weather variables investigated.
Conclusions: While alternate conclusions can be drawn, we propose
that the data support the interpretation that low barometric
pressure is associated with an increase in impulsive behaviours.
Additional investigation is warranted.
Clinical Implications
_ Behaviour is a product of multiple factors, some of which are
subtle.
_ Subjective patient reports of being affected by weather variables
may be valid.
_ Impulsive or violent behaviour may increase when barometric
pressure is low.
Limitations
_ This associational study provides no reliable information regarding
causality.
_ The effect size observed may be too small to be clinically useful,
and replication is essential to ensure that findings are not
accidental.
_ Elements of the study design may have reduced or magnified the
effect size.
Results
In 1999, there were 4717 visits to EPS, with 1165 patients placed in
the HBU and 1585 patients admitted to the hospital. There were
3804 violent criminal acts and 71 suicides reported in the 337 days
of the study period.
Barometric pressure was significantly correlated with the number of
EPS visits (r2 = 0.017, P = 0.0178) and total acts of violence (r2 =
0.015, P = 0.0257). There were no significant relations between
barometric pressure and HBU admissions (r2 = 0.005, P = 0.19),
inpatient admissions (r2 = 0.002, P = 0.36), or suicides (r2 =
0.003, P = 0.3).
Wind speed, which is related to periods of changing pressure, was
associated with total violence (r2 = 0.019, P = 0.012), but no other
associations were found (EPS visits r2 = 0.002, P = 0.39; HBU r2 =
0.001, P = 0.62; inpatient r2 = 0.01, P = 0.07; suicide r2 = 0.005,
P = 0.018). Relative humidity was not associated with any of the
measured variables (EPS visits r2 = 0.0003, P = 0.72; HBU r2 =
0.001, P = 0.66; inpatient r2 = 0.00007, P = 0.88; total violence r2
= 0.007, P = 0.14;
suicide r2 = 0.003, P = 0.34).
In 1999, barometric pressure in Louisville was significantly higher in
winter (92.59 [SD 0.191] inH2 O) than in spring (29.51 [SD 0.165]
inH2 O) (F = 3.85, P < 0.05) and summer (29.48 [SD 0.113] inH2
O) (F = 6.12, P < 0.05), but not autumn (29.957 [SD 0.156] inH2
O) (F = 0.26). EPS visits were greater in summer (mean visits
daily15.0, SD 4.3) than in winter (mean visits daily 12.8, SD 3.7) (F
= 4.223, P < 0.05), but not significantly different in spring (mean
visits daily 14.0, SD 4.0) or in autumn (mean visits daily 13.8, SD
4.4). The use of the HBU was least in spring (mean patients daily
3.0, SD 1.5), compared with summer (mean patients daily 3.7, SD
1.5) (F = 2.94, P < 0.05) and autumn (mean patients daily 3.8, SD
1.8) (F = 3.99, P < 0.05), but not when compared with winter
(mean patients daily 3.2, SD 1.5) (F = 0.213). There were no
seasonal differences in the rates of inpatient admissions daily
(winter mean 4.3, SD 2.2; spring mean 5.0, SD 2.4; summer mean
5.0, SD 2.4; autumn mean 4.5, SD 2.3; analysis of variance [ANOVA]
P = 0.12).
Discussion
This study found weak, but significant, correlations between low
barometric pressure and the total number of emergent psychiatric
visits and total reported acts of violent crime. There were no
significant relations between barometric pressure and HBU
admissions, inpatient admissions, or suicides. There were no
associations between any of the behavioural variables and wind