近日，澳大利亚莫纳什大学Shanshan Li团队研究了绿化与特定原因精神障碍的住院情况：多国时间序列研究。该项研究成果发表在2025年11月5日出版的《英国医学杂志》上。

为了研究绿化暴露与精神障碍住院率之间的关系，并估计不同绿化干预方案下与绿化相关的住院率，研究组进行了一项多国时间序列研究，6842个地点分布在7个国家（澳大利亚、巴西、加拿大、智利、新西兰、韩国和泰国）。

2000-2019年有1140万人因精神疾病住院。主要结局为所有原因的精神障碍和与绿色有关的六类（由标准化植被差异指数（NDVI）衡量）的住院人数：精神障碍、物质使用障碍、情绪障碍、行为障碍、痴呆和焦虑。使用准泊松回归模型估计关联，控制了天气条件、空气污染物、社会经济指标、季节性和长期趋势。模型按性别、年龄、城市化程度和季节进行分层。评估不同绿化干预方案下的住院率。

2000-2019年期间，在与精神健康障碍有关的住院病例中，30.8%（3522749名患者）患有精神病，24.7%（2821860名）患有物质使用障碍，11.6%（1325305名）患有情绪障碍，7.4%（845561名）患有行为障碍，3.0%（348149名）患有痴呆症，2.5%（283914名）患有焦虑症。在合并分析中，NDVI增加0.1与全因精神障碍住院风险降低7%相关（相对风险0.93，95%置信区间（CI）0.89至0.98）。然而，不同国家和疾病类型之间的关联各不相同。

巴西、智利和泰国在大多数疾病类别中表现出一致的保护性关联，而在澳大利亚和加拿大，对于全因精神障碍和几种特定疾病类别的住院，观察到适度的不良（即有害）关联。暴露反应分析显示，在没有明确阈值的情况下，通常呈单调和近似线性关系。当仅限于关联通常更一致的城市环境时，城市地区每年因精神健康障碍入院的估计人数为7712人（95%CI 6701至8726人），这在统计上可归因于观察到的绿色水平。城市地区绿色干预情景分析表明，绿色增加10%与精神障碍住院人数减少有关，韩国为每10万人中约1人，新西兰为每10万人中约1000人。

研究结果表明，在几个国家，特别是在城市环境中，绿色与精神障碍住院风险较低有统计学关联。然而，观察到了一些不良关联，并且发现在不同背景下存在异质性。

附：英文原文

Title: Greenness and hospital admissions for cause specific mental disorders: multicountry time series study

Author: Tingting Ye, Wenzhong Huang, Zhihu Xu, Rongbin Xu, Pei Yu, Yao Wu, Yiwen Zhang, Wenhua Yu, Yanming Liu, Bo Wen, Ke Ju, Zhengyu Yang, Shuang Zhou, Samuel Hundessa, Simon Hales, Eric Lavigne, Patricia Matus, Kraichat Tantrakarnapa, Ho Kim, Micheline de Sousa Zanotti Stagliorio Coelho, Paulo Saldiva, Yuming Guo, Shanshan Li

Issue&Volume: 2025/11/05

Abstract:

Objectives To examine the association between exposure to greenness and hospital admissions for mental disorders, and to estimate greenness related hospital admissions under various greenness intervention scenarios.

Design Multicountry time series study.

Setting 6842 locations in seven countries (Australia, Brazil, Canada, Chile, New Zealand, South Korea, and Thailand).

Participants 11.4 million hospital admissions for mental disorders, 2000-19.

Main outcome measures Hospital admissions for all cause mental disorders and for six categories in relation to greenness (measured by the normalised difference vegetation index (NDVI)): psychotic disorders, substance use disorders, mood disorders, behavioural disorders, dementia, and anxiety. Associations were estimated using quasi-Poisson regression models, controlled for weather conditions, air pollutants, socioeconomic indicators, seasonality, and long term trends. Models were stratified by sex, age, urbanisation, and season. Hospital admissions were estimated under different greenness intervention scenarios.

Results During 2000-19, of hospital admissions related to mental health disorders, 30.8% (3522749 patients) were for psychotic disorders, 24.7% (2821860) for substance use disorders, 11.6% (1325305) for mood disorders, 7.4% (845561) for behavioural disorders, 3.0% (348149) for dementia, and 2.5% (283914) for anxiety. A 0.1 increase in NDVI was associated with a 7% reduction in the risk of hospital admissions for all cause mental disorders (relative risk 0.93, 95% confidence interval (CI) 0.89 to 0.98) in pooled analyses. However, associations varied across countries and disorder types. Brazil, Chile, and Thailand showed consistent protective associations across most disorder categories, while modest adverse (ie, harmful) associations were observed in Australia and Canada for hospital admissions for all cause mental disorders and for several specific disorder categories. Exposure-response analyses showed a generally monotonic and approximately linear relation without clear thresholds. When limited to urban settings where associations were generally more consistent, an estimated 7712 (95% CI 6701 to 8726) hospital admissions for mental health disorders annually in urban areas were statistically attributable to observed greenness levels. Analysis by greenness intervention scenarios in urban areas suggested that a 10% increase in greenness was associated with reductions in hospital admissions for mental disorders ranging from ~1 per 100000 in South Korea to ~1000 per 100000 in New Zealand.

Conclusions Greenness was statistically associated with lower risks of hospital admissions for mental disorders in several countries, particularly in urban settings. Some adverse associations were, however, observed, and findings were heterogeneous across contexts.

DOI: 10.1136/bmj-2025-084618

Source: https://www.bmj.com/content/391/bmj-2025-084618