[MCN] Fossil fuels -> heat -> violence, impaired cognition, loss of sleep, impact on psychiatric patients

[Lance Olsen]

Excerpts
Violence. Evidence linking extreme heat and aggression confirms the general understanding expressed in our colloquial language of “hot headed,” “so hot my blood boils.” One standard deviation of temperature increase leads to a 4% increase in interpersonal violence and 14% increase in group violence.5,6 This has significant implications for domestic violence and impacts on women and children. Burke and colleagues 6 warn “Because locations throughout the inhabited world are expected to warm 2 to 4 degrees by 2050, amplified rates of human conflict could represent a large and critical impact of anthropogenic climate change.” Increases of 2 to 10 degrees due to “urban heat islands” caused by asphalt and concrete structures and limited green space compared to adjacent suburban and rural communities may be contributors to increased summer violence in inner cities.”

Cognition.Complex cognitive tasks such as working memory (spatial span test, pattern recognition) have been observed to be significantly impaired because of heat stress.10

Insomnia. Sleep is an essential function for overall well-being and health with adverse impacts of sleep deprivation on mood, depression, and cognition. Normal sleep onset and maintenance is triggered by a drop in core body temperature. Increased heat contributes to insomnia and worsens in combination with increased humidity, with the potential to aggravate all psychiatric difficulties and coping abilities.11 This has implications for urban residents who live in areas where heat is trapped and for people who do not have access to air-conditioning or cool respite places.

Especially vulnerable psychiatric patients

Patients with severe psychotic or mood disorders, substance abuse disorders, or cognitive impairments, who are able to compensate with marginal executive functioning during periods of normal weather, are challenged during intense heat and can lose their fragile ability to make plans, have good judgment, and effectively care for themselves. These patients are more likely to experience heat stroke and other heat-related morbidity. Evidence supports these impacts on psychiatric patients:

• Emergency department utilization and hospitalization increase for patients with preexisting psychiatric illness during heat waves12,13

• Preexisting mental illness alone raises the risk of mortality during extreme heat events 2- to 3-fold14,15

• Patients with schizophrenia may have underlying impairments in thermo-regulation (intrinsic to the disease), which might explain the perplexing sight of psychotic patients bundled up in layers on hot days16

• Psychiatric medications (eg, antipsychotics, anticholinergic antidepressants) have the potential to impair the body’s heat regulatory functioning; sweating and dehydration can increase lithium levels, putting patients at greater risk for dangerous toxicity during heat waves17

As mental health providers, we must educate both our patients and colleagues, and collaborate with leaders in the public health delivery systems to design preventive and intervention strategies to protect our vulnerable patients and communities from the adverse effects of extreme heat.

The CDC has many available resources including a brochure to guide program development and patient interventions (see Infographic).18However, we cannot stop there. We must go further and use our professional voices to advocate for policies that get at the root causes of global warming.

End of excerpts

https://www.psychiatrictimes.com/climate-change/impacts-extreme-heat-mental-health <https://www.psychiatrictimes.com/climate-change/impacts-extreme-heat-mental-health>
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“It’s time that everyone, from the humble homeowner to the highest levels of business and government, rethink their relationship with energy and take action. Relying on renewables alone won’t be enough.”

https://www.forbes.com/sites/mikehughes1/2019/08/02/climate-change-18-months-to-save-the-world/#166763c749bd



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