Growing evidence suggests that air pollution exposure may adversely affect the brain and increase risk for psychiatric disorders such as schizophrenia and depression. However, little is known about the potential role of air pollution in severity and relapse following illness onset.

To examine the longitudinal association between residential air pollution exposure and mental health service use (an indicator of illness severity and relapse) among individuals with first presentations of psychotic and mood disorders.

We identified individuals aged ≥15 years who had first contact with the South London and Maudsley NHS Foundation Trust for psychotic and mood disorders in 2008–2012 (n = 13 887). High-resolution (20 × 20 m) estimates of nitrogen dioxide (NO2), nitrogen oxides (NOx) and particulate matter (PM2.5 and PM10) levels in ambient air were linked to residential addresses. In-patient days and community mental health service (CMHS) events were recorded over 1-year and 7-year follow-up periods.

Following covariate adjustment, interquartile range increases in NO2, NOx and PM2.5 were associated with 18% (95% CI 5–34%), 18% (95% CI 5–34%) and 11% (95% CI 3–19%) increased risk for in-patient days after 1 year. Similarly, interquartile range increases in NO2, NOx, PM2.5 and PM10 were associated with 32% (95% CI 25–38%), 31% (95% CI 24–37%), 7% (95% CI 4–11%) and 9% (95% CI 5–14%) increased risk for CMHS events after 1 year. Associations persisted after 7 years.

Residential air pollution exposure is associated with increased mental health service use among people recently diagnosed with psychotic and mood disorders. Assuming causality, interventions to reduce air pollution exposure could improve mental health prognoses and reduce healthcare costs.

越来越多的证据表明，空气污染暴露可能会对大脑产生不利影响，并增加精神分裂症和抑郁症等精神疾病的风险。然而，人们对空气污染在疾病发作后严重程度和复发方面的潜在作用知之甚少。

在首次出现精神病和情绪障碍的个体中检查住宅空气污染暴露与心理健康服务使用（疾病严重程度和复发的指标）之间的纵向关联。

我们确定了 2008-2012 年首次与南伦敦和 Maudsley NHS 基金会就精神病和情绪障碍接触的 15 岁以上的个体（n = 13 887）。环境空气中二氧化氮 (NO 2 )、氮氧化物 (NO x ) 和颗粒物 (PM 2.5和 PM 10 ) 水平的高分辨率 (20 × 20 m) 估计值与住宅地址相关联。在 1 年和 7 年的随访期内记录了住院天数和社区心理健康服务 (CMHS) 事件。

协变量调整后，NO 2、NO x和 PM 2.5的四分位间距增加与 18% (95% CI 5–34%)、18% (95% CI 5–34%) 和 11% (95% CI 3 –19%) 1 年后住院天数的风险增加。同样，NO 2、NO x、PM 2.5和 PM 10的四分位间距增加与 32% (95% CI 25–38%)、31% (95% CI 24–37%)、7% (95% CI 4–11%) 和 9% (95% CI 5–14%) 增加 1 年后发生 CMHS 事件的风险。协会在 7 年后仍然存在。

住宅空气污染暴露与最近被诊断患有精神病和情绪障碍的人的心理健康服务使用增加有关。假设因果关系，减少空气污染暴露的干预措施可以改善心理健康预后并降低医疗成本。