Susceptibility of persons with schizophrenia to extreme heat: A critical review of physiological, behavioural, and social factors

IF 8 1区 环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES
Nathalie V. Kirby , Emily J. Tetzlaff , Sean A. Kidd , Eric E. Brown , Mariya Bezgrebelna , Liv Yoon , Sarah B. Henderson , Glen P. Kenny
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Abstract

Schizophrenia is a severe mental illness affecting approximately 24 million people worldwide. Schizophrenia diagnosis is associated with more than double the all-cause mortality risk of the general population and a 13- to 15-year reduction in life expectancy, due to a myriad of intersecting factors and underlying causes. Persons with schizophrenia are particularly susceptible to the negative health effects of extreme heat, as demonstrated by the 2021 Western North America Heat Dome. During this event, schizophrenia was associated with a 3-fold increase in the odds of mortality in British Columbia, Canada, far surpassing the risks associated with other common heat-sensitive chronic conditions, including diabetes, hypertension, and heart disease. While individual factors such as age, presence of chronic disease, and medication-use can impair thermoregulation and limit a person's ability to sense and respond to heat, physiological and behavioural factors associated with schizophrenia can exacerbate these impairments. In-turn, social and community-level factors play important roles in aggravating or mitigating heat-health risks. However, to date, our understanding of the separate and combined influence of the physiological, behavioural, and social determinants underpinning heat-susceptibility in individuals with schizophrenia remains largely unresolved. We therefore conducted a critical review to examine the physiological factors that can increase susceptibility to the negative effects of heat in persons with schizophrenia and profile the social and community-level factors aggravating or mitigating these risks. An interdisciplinary, multi-level approach is essential to facilitate effective heat-health planning and community adaptation to prevent heat-related injuries and deaths in persons with schizophrenia during extreme heat.

Abstract Image

精神分裂症患者对极端高温的易感性:生理、行为和社会因素的重要回顾
精神分裂症是一种严重的精神疾病,影响着全世界大约2400万人。精神分裂症的诊断与普通人群的全因死亡风险增加一倍以上以及预期寿命减少13至15年有关,这是由于无数交叉因素和潜在原因造成的。正如2021年北美西部热穹顶所证明的那样,精神分裂症患者特别容易受到极端高温对健康的负面影响。在这一事件中,在加拿大不列颠哥伦比亚省,精神分裂症与死亡率增加3倍相关,远远超过其他常见的热敏性慢性病(包括糖尿病、高血压和心脏病)相关的风险。虽然年龄、慢性疾病和药物使用等个人因素可能损害体温调节并限制一个人对热的感知和反应能力,但与精神分裂症相关的生理和行为因素可能加剧这些损害。反过来,社会和社区层面的因素在加重或减轻热健康风险方面发挥着重要作用。然而,到目前为止,我们对精神分裂症患者热易感性的生理、行为和社会决定因素的单独和综合影响的理解在很大程度上仍未得到解决。因此,我们进行了一项重要的综述,以检查可能增加精神分裂症患者对热的负面影响的易感性的生理因素,并描述社会和社区水平的因素加重或减轻这些风险。跨学科、多层次的方法对于促进有效的热健康规划和社区适应至关重要,以防止极端高温期间精神分裂症患者的热相关伤害和死亡。
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来源期刊
Science of the Total Environment
Science of the Total Environment 环境科学-环境科学
CiteScore
17.60
自引率
10.20%
发文量
8726
审稿时长
2.4 months
期刊介绍: The Science of the Total Environment is an international journal dedicated to scientific research on the environment and its interaction with humanity. It covers a wide range of disciplines and seeks to publish innovative, hypothesis-driven, and impactful research that explores the entire environment, including the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. The journal's updated Aims & Scope emphasizes the importance of interdisciplinary environmental research with broad impact. Priority is given to studies that advance fundamental understanding and explore the interconnectedness of multiple environmental spheres. Field studies are preferred, while laboratory experiments must demonstrate significant methodological advancements or mechanistic insights with direct relevance to the environment.
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