Temperature exposure and psychiatric symptoms in adolescents from 2 european birth cohorts

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• dc.contributor.author Essers, Esmée
• dc.contributor.author Kusters, Michelle S.W.
• dc.contributor.author Granés, Laura
• dc.contributor.author Ballester, Joan
• dc.contributor.author Petricola, Sami
• dc.contributor.author Lertxundi, Nerea
• dc.contributor.author Arregi, Ane
• dc.contributor.author Ballester Díez, Ferran
• dc.contributor.author Vrijheid, Martine
• dc.contributor.author El Marroun, Hanan
• dc.contributor.author Iñiguez, Carmen
• dc.contributor.author Tiemeier, Henning
• dc.contributor.author Guxens Junyent, Mònica
• dc.date.accessioned 2025-04-09T06:45:52Z
• dc.date.available 2025-04-09T06:45:52Z
• dc.date.issued 2025
• dc.description.abstract Importance: Climate change can adversely affect mental health, but the association of ambient temperature with psychiatric symptoms remains poorly understood. Objective: To assess the association of ambient temperature exposure with internalizing, externalizing, and attention problems in adolescents from 2 population-based birth cohorts in Europe. Design, setting, and participants: This cohort study analyzed data from the Dutch Generation R Study and the Spanish INMA (Infancia y Medio Ambiente) Project. Generation R recruited 9898 women during pregnancy or shortly after birth, with children born between 2002 and 2006. INMA recruited 2270 pregnant women from Gipuzkoa, Sabadell, and Valencia, Spain, with children born between 2003 and 2008. Individuals born from live singleton births with available outcome and exposure data were included in the study. Data were analyzed between October 2023 and November 2024. Exposure: Daily ambient temperature 2 weeks, 1 month, and 2 months preceding outcome assessment was calculated between December 2015 and November 2022 at the residence at 100 × 100 m resolution utilizing the UrbClim model. Main outcomes and measures: The primary outcomes were internalizing, externalizing, and attention problems, measured with the maternal-reported Child Behavioral Checklist for ages 6 to 18 years; raw scores were square-root transformed, with higher scores indicating more problems. Distributed lag nonlinear models evaluated the associations of temperature exposure with problem scores in each country and region. For Spain, results from the 3 INMA regions were combined using random-effects meta-analysis. Results show the accumulated temperature association over each exposure period. Results: A total of 3934 participants from Generation R (mean [SD] age at assessment, 13.6 [0.4] years; 1971 female [50%]) and 885 from INMA (mean [SD] age at assessment, 14.9 [1.0] years; 458 female [52%]) were included. Most parents in both cohorts were native to the respective countries of each cohort and had relatively high socioeconomic status. Daily temperatures ranged from -5.2 °C to 32.6 °C in the Netherlands and 3.3 °C to 33.9 °C in Spain. In Generation R, the mean (SD) square-root transformed scores were 2.0 (1.2) for internalizing problems, 1.6 (1.3) for externalizing problems, and 1.5 (1.0) for attention problems, while in INMA these were 2.4 (1.2), 2.1 (1.3), and 1.5 (1.1), respectively. In the Netherlands, cumulative exposure to cold was associated with more internalizing problems (eg, 0.76 [95% CI, 0.20-1.32] higher square-root points at 5.5 °C exposure over a 2-month exposure). In Spain, cumulative exposure to heat was associated with more attention problems (eg, 1.52 [95% CI, 0.39-2.66] higher square-root points at 21.7 °C exposure over a 2-month exposure). Conclusions and relevance: In this cohort study, exposure to cold in the Netherlands and heat in Spain were associated with more psychiatric symptoms, highlighting distinct temperature exposure and mental health associations among adolescents. Future studies should explore this across diverse climates to further quantify the intricate and multifactorial association of climate change with mental health.
• dc.description.sponsorship The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the Faculty of Social Sciences of the Erasmus University Rotterdam; the Municipal Health Service Rotterdam area, Rotterdam; the Rotterdam Homecare Foundation, Rotterdam; and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond, Rotterdam. The general design of the Generation R Study is made possible by financial support from the Erasmus Medical Center, Rotterdam; Erasmus University, Rotterdam; the Netherlands Organization for Health Research and Development; and the Ministry of Health, Welfare and Sport. The INMA (Infancia y Medio Ambiente) Project is funded by the Instituto de Salud Carlos III (grant Nos. Red INMA G03/176, CB06/02/0041, PI03/1615, PI04/1509, PI04/2018, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/02647, PI09/00090, PI09/02311, PI11/01007, PI11/02591, PI11/02038, PI12/00610, PI13/1944, PI13/2032, PI13/02187, PI13/02429, PI14/00891, PI14/01687, PI16/1288, PI17/00663, PI18/00909, PI18/01142, PI19/1338, PI20/01695, and PI23/1578), the European Union (grant Nos. FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1, cod 874583, and cod 101136566), Miguel Servet-European Regional Development Fund (Fondo Europeo de Desarrollo Regional [FEDER]; grant Nos. CP11/00178, CP15/00025, CPII16/00051, CPII18/00018, MSII16/00051, and MS20/0006), Generalitat Valenciana (grant Nos. CIAICO/2021/132, BEST/2020/059, AICO 2020/285, AICO/2021/182, and CIDEGENT/2019/064), Consejo General de Enfermería (grant No. PNI22_CGE45), Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (grant Nos. UGP 15-230, UGP-15-244, and UGP-15-249), the Alicia Koplowitz Foundation 2017, Spanish Consortium for Research on Epidemiology and Public Health, Fundación Cajastur and Universidad de Oviedo, the Department of Health of the Basque Government (grant Nos. 2005111093, 2009111069, 2013111089, and 2015111065), the Provincial Government of Gipuzkoa (grant Nos. DFG06/002, DFG08/001 and DFG15/221), the Generalitat de Catalunya-CIRIT (Catalan National Science Foundation; grant No. 1999SGR 00241), and annual agreements with the municipalities of the Gipuzkoa study area (Zumarraga, Urretxu, Legazpi, Azkoitia, Azpeitia, and Beasain). The authors acknowledge support from the Ministerio de Ciencia, Innovación y Universidades and Agencia Estatal de Investigación (Ministry of Science, Innovation and Universities and State Research Agency [MCIN/AEI]; grant No. CEX2023-001290-S funded by MCIN/AEI/10.13039/501100011033), support from the Generalitat de Catalunya through the CERCA (Research Centers of Catalonia) Program, and from the Ministry of Research and Universities of the Government of Catalonia (grant No. 2021 SGR 01564). This study also received funding from the Agence Nationale de Securite Sanitaire de l’Alimentation de l’Environnement et du Travail (grant No. EST-18 RF-25), and the European Union Horizon 2020 research and innovation programme (grant agreement No. 874583, Advancing Tools for Human Early Lifecourse Exposome research and Translation). Dr J. Ballester was supported by the European Union Horizon 2020 and Horizon Europe research and innovation programmes (grant agreement Nos. 865564 [European Research Council Consolidator grant EARLY-ADAPT], 101069213 [European Research Council Proof-of-Concept HHS-EWS], and 101123382 [European Research Council Proof-of-Concept FORECAST-AIR]), and the Spanish Ministry of Science and Innovation (grant agreement No. RYC2018-025446-I [programme Ramón y Cajal]). Dr El Marroun was supported by Stichting Volksbond Rotterdam and the Netherlands Organization for Scientific Research (Aspasia grant No. 015.016.056). Dr Tiemeier was supported by the European Union Horizon Europe Research and Innovation Programme (grant agreement No. 101057529 [FAMILY]). Dr Granés was supported by the Spanish Institute of Health Carlos III (Rio Hortega fellowship No. CM22/00011). This publication was cofinanced by the AEI and the European Social Fund (FSE; reference No. PRE2020-092005) according to the Resolution of the Presidency of the AEI, by which grants are awarded for predoctoral contracts for the training of physicians, call 2020 (awarded to Dr Kusters).
• dc.format.mimetype application/pdf
• dc.identifier.citation Essers E, Kusters M, Granés L, Ballester J, Petricola S, Lertxundi N, et al. Temperature exposure and psychiatric symptoms in adolescents from 2 european birth cohorts. JAMA Netw Open. 2025 Jan 2;8(1):e2456898. DOI: 10.1001/jamanetworkopen.2024.56898
• dc.identifier.doi http://dx.doi.org/10.1001/jamanetworkopen.2024.56898
• dc.identifier.issn 2574-3805
• dc.identifier.uri http://hdl.handle.net/10230/70113
• dc.language.iso eng
• dc.publisher American Medical Association
• dc.relation.ispartof JAMA Netw Open. 2025 Jan 2;8(1):e2456898
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/282957
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/874583
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101136566
• dc.relation.projectID info:eu-repo/grantAgreement/ES/3PE/CEX2023-001290-S
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/874583
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/865564
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101069213
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101123382
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RYC2018-025446-I
• dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101057529
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/PRE2020-092005
• dc.rights © 2025 Essers E et al. JAMA Network Open. This is an open access article distributed under the terms of the CC-BY License (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.other Salut mental
• dc.subject.other Canvis climàtics
• dc.title Temperature exposure and psychiatric symptoms in adolescents from 2 european birth cohorts
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion