INTRODUCTION

The influence of moon phases on humans has been studied for many years. There are both a rich mythology and a biased attitude of researchers. There are various hypotheses explaining the influence of the moon cycle on the physiology of living organisms via a lighting level (which indirectly affects a melatonin level), electromagnetic radiation, and gravitational attraction of the moon (tidal forces) (Myers, 1995; Raison et al., 1999; Zimecki, 2006; Gerasimov et al., 2014).

The results of the studies conducted based on a qualitative methodology (with a large sample size for many years and consideration of other geophysical interfering factors) in the different medical spheres do not show any sign that moon phases affects the state of human health.

As an example, moon phases do not affect the date and frequency of births (Schuld et al., 2011; Bauer et al., 2013), incidence of diseases, mortality, and long-term survival after living donor renal transplantation (Kleespies et al., 2017), the occurrence of perioperative complications and results of planned back surgeries (Joswig et al., 2016), surgical blood loss, and the frequency of emergencies (Marco-Gracia, 2019).

The moon phases are also not related to the frequency of ruptures of intracranial aneurysms (Bunevicius et al., 2017), the frequency of aneurysmal subarachnoid hemorrhages, or localization of aneurysms, and the initial clinical picture or volume of subarachnoid hemorrhages (Kamp et al., 2013).

However, opposite results have also been obtained during the study of this issue. The works (Ali et al., 2008; Banfield et al., 2017) showed that moon phases exert some influence on the frequency of ruptures of intracranial aneurysms. It is worth noting that the indicated works analyzed small samples without describing the groups of patients, while the methods of statistical analysis were not described in detail.

The influence of moon phases on the aggravation of mental illnesses, including distinct manifestations of behavioral disorders (Calver et al., 2009), significant changes in mental state of patients with schizophrenia (Barr, 2000), incidence of nonaffective psychoses (Parmeshwaran et al., 1999), and the development of acute exacerbations of psychiatric disorders and other pathological behaviors (Parmar et al., 2014) has also been examined for many years.

The information on the influence of this type of biorhythm on the state of mental health is of interest for medical practice, since it can be useful in planning the work of emergency medical services (Zimecki, 2006).

This work was aimed at considering the hypothesis on the influence of moon phases on frequency of urgent and emergency admissions of persons with mental disabilities to a psychiatric hospital based on the local data.

MATERIALS AND METHODS

The study was conducted using anonymous medical records files of Russians with mental disabilities. The influence of moon phases on the frequency of urgent and emergency admissions of patients with indications for urgent and emergency (including, involuntary) admissions to a psychiatric hospital in accordance with the law on psychiatric support in Russia (Rozhdestvina, 2006; Nikulinskaya et al., 2014; Law of the Russian Federation…, 2021) with indications for urgent and emergency admissions of patients to a psychiatric hospital, which were included in the updated clinical guidelines on schizophrenia, affective, and cognitive disorders (Clinical recommendations “Cognitive…,” 2020; Clinical recommendations “Bipolar…,” 2021; Clinical recommendations “Depressive…,” 2021; Clinical recommendations “Schizophrenia,” 2021) was investigated.

These include patients with severe mental disorders (both with mental disorders that appeared for the first time and exacerbations of chronical diseases): disorders of a schizophrenia spectrum, affective disorders, organic mental affections, with manifested suicidal tendences, aggression towards the environment, pronounced psychotic, affective, and cognitive symptoms.

We analyzed all the admissions to the psychiatric facility of the Evgrafov Regional Mental Hospital (Penza) for urgent and emergency indications and for referral from a brigade of special medical aid to the facility of intensive psychiatric support over the period from January 1, 2018 to December 31, 2019. This time span was not chosen randomly, it was the time before the outbreak of the pandemic of the new coronavirus infection (COVID-19) (Listings of WHO’s response…, 2021), which affected different factors related to health (indicators of the public health system, mortality rate, incidence rate, etc.).

We compared the number of urgent and emergency admissions to the psychiatric hospital in the different moon phases of the full moon, new moon, first quarter, and last quarter. For the calculations, we used moon phase tables (Tables …, 2021) and the special algorithm from (Meeus, 1988). The number of admitted patients over 3 days was estimated: directly on the day of the moon phase, on the day before, and the day after the phase (Table 1). The 3-day span for estimating the number of hospital admissions was determined by the hypothesis that the influence of the moon phases is not discrete but can gradually intensify and weaken in the period that is closer and farther from the value of a date for a particular phase. A similar approach was used in some international studies of the influence of the moon phase on human physiology (Amaddeo et al., 1997; Parmar et al., 2014; Gupta et al., 2019).

Table 1.   The number of urgent and emergency admissions of patients to the psychiatric facility of Evgrafov Regional Mental Hospital, Penza, in 2018–2019
Full size table

A total of 99 periods of different moon phases occurred over the studied time span (24–25 periods of each moon phase). The size of the studied group was 450 persons, including 222 men (49%) and 228 women (51%), at ages from 8 to 90 years (the average age is 42.8 ± 17.9 yr). The range of disorders in the study group was represented by 331 (74%) cases of pronounced psychotic disorders and 119 (26%) cases of pronounced nonpsychotic (affective and behavioral) disorders.

The statistical processing of the data was conducted using STATISTICA 6.0 software. Taking the absence of normal distribution of admission frequency in the periods of different moon phases (full moon, new moon, first quarter, and last quarter) into account, as well as the comparatively small sample size in these groups, we used a counterpart of the method of one way analysis of variance ANOVA with the Kruskal–Wallis criterion for the statistical processing of the data.

DISCUSSION

The statistical processing of the obtained data revealed the absence of statistically significant differences (p = 0.4382) in the frequencies of urgent and emergency admissions to the psychiatric hospital in the different moon phases. We note that the majority of the international researchers did not detect the influence of the moon phases on mental health (Gorvin and Roberts, 1994; Amaddeo et al., 1997; Owen et al., 1998; McLay et al., 2006; Kamat et al., 2014; Parmar et al., 2014; Francis et al., 2017; Gupta et al., 2019).

The Russian population has not often been involved in these scarce studies. The results of some works are ambiguous (Karepina et al, 2007; Krasil’nikova and Chanzan, 2018), while others based on the analysis of a large volume of data and aimed at studying particular issues, such as, e.g., the influence of moon phases on the suicide rate (Ezugbaya et al., 2012; Sapozhnikov et al., 2020; Fedin et al., 2020) did not record such a correlation.

Thus, the obtained results about the influence of the moon phases on mental health based on the analysis of the local population in general agree with the results of international researchers (Gorvin and Roberts, 1994; Amaddeo et al., 1997; Owen et al., 1998; McLay et al., 2006; Kamat et al., 2014; Parmar et al., 2014; Francis et al., 2017; Gupta et al., 2019).

CONCLUSIONS

The results of analyzing the number of admissions for urgent and emergency indications to the psychiatric facility of Evgrafov Regional Mental Hospital, Penza, support the conclusions in numerous international studies that moon phases have no influence on the frequency of exacerbations of mental disorders.