Lunar Phase and Psychiatric Illness in Goa - Parameshwaran Ramakrishnan - Indian Journal of Psychiatry 1999, 41 (1), 60-65

8/12/2019 Lunar Phase and Psychiatric Illness in Goa - Parameshwaran Ramakrishnan - Indian Journal of Psychiatry 1999, 41

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Indian JournalofPsychiatry, 1999, 41 (1), 60-65

LUNAR PHASE AND PSYCHIATRICILLNESS IN GOAR. PARMESHWARAN, V. PATEL & J.M. FERNANDES

ABSTRACTTherehas been co nsiderable research on the influence of the lunar cycle on men tal illness

with conflictingfindings.The objective of this study w as to determ ine the relationship between fullmoo n (FM), new moo n (NM ), and other moo n (OM ) days and the freque ncy of specific psychiatricdisorders in patients seen at a tertiary psychiatric hospital in Goa and to examine relationshipswith eclipses. Analysis of all new patients in two calendar years (1997 1993) was carried out.Diagnoses of interest were : Non affective psychoses; depression; and mania. The numbers ofnew patients seen at the OPD oftheInstitute of Psychiatry HumanBehaviour Goa, with thesediagnoses were compared between FM , NM and OM days.Numb ers of patients with these diagnoses on eclipse days (lunar/solar) were also examined. A significant trend was observed forgreater numbers of patients with non-affective psychoses on FM days, but no pattern wasobserved for mania or depression. The excess of non-affective psychoses was more marked ondays of a visible lunar eclipse. A relationship be tween FM and non-affective psychose s has beendem onstrated. Its implications for further research and the potential mecha nism to explain thesefindings are discussed.

Key Words :lunar eclipse, psychoses, men tal illnessThe belief in the effect of the lunar cycleon human and animal behaviour has beenpresent for centuries and is immo rtalized in theword lunatic , once used to describe the mentally ill. A review of the literature on the association of psychiatric illness and the lunar cyclereveals a diverse and conflicting set of findings.

Associations have been reported between thelunar cycle and parasuicide case adm itted tohospitals, with the peaks occurring at fullmoo nand newmoon (Rogers et al., 1991). Similarassociations have been demonstrated for homicides (Lieber & Sherin, 1972). De Castro &Pearcey (1995) demonstrate an 8% increase inmeal size and a 26% decrease in alcohol intake at the time of the full moon relative to thenew m oon, thus suggesting that there is a trueinternal lunar rhythm which influences nutrient

intakes of normal humans in their naturalenvironm ent. A significant lunar periodicity has beenobserved for the number of accidents, thehighest number being two days before fu l lmoon (Alonso, 1993). The mean number ofmisbehaviours in a population of developmen-tally delayed institutionalised w omen on the dayof full moon was significantly higher than themean number on any other day of the lunarperiod (Hicks-Caskey & Potter, 1991). In contrast, many authors (e.g. Be ue r&H orn ic, 1968;L i l i en fe l d , 1969; Laver ty e t a l . , 1992;Vijaylakshmi & Ramakrishna, 1992) failed todemonstrate any relationship between lunarphase and m ental illness. All these authors examined the daily total number of cases at thepsychiatric emergency room without classifyingthem into any diagnostic group. Wilkinson et

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al.(1997) did not find an influence of the moonof the freque ncy of consultations for an xiety ordepression in general practice.The objective of this study was to determine the relationship between full mo on (FM),new moon (NM), and other moon (OM) daysand the freque ncy of spe cific p sychiatric disorders in patients seen at a tertiary psychiatrichospital in Goa and to examine relationshipswith lunar and solar eclipses.MATERIAL AND METHOD

Design : Prosp ective Case - Se ries fromJanuary 1st, 1997 for 12 months. Upon findingsa trend for greater number of admissions fornon-affective psychoses during this prospectiveseries, a retrospective Case-Note survey for1993 was car r ied ou t to conf i rm th isassociation.

All new a ttenders at the ou tpatient clinicof the Institute of Psychiatry & Human Behav-iourduring two calendar years, viz., 1993 &1 997formed sample of the present study.Data Collected from Case Notes were dateof consu ltation, gender & psychiatric diagnosesaccording to ICD-10 (WHO. 1992).For lunar cycle dates, the\unarphase andeclipses were plotted by using standard astro-calendars (Astro-Research Bureau, 1993 &1997).

The definitions related to the topic are :Apogee : farthest distance of the moon fromthe earth,Perigee : closest distance of the moon to theearth,Aphelion : farthest distance of the earth fromthe sun,Perihelion : closet distance of the earth to thesun.Analysis : The mean number of patients for 13diagnostic grou p, viz., Non - affective psychoses (P), Depression (D) and Mania (M) werecomp ared for the following types of days of the

lunar cycle : Full Moon (FM) days; New Moon(NM), days, Other Moon (OM) days; solareclipses ; and lunar ec lipses (visible or no n-visible). One way analysis of variance w as used tocompare the m ean num ber of subjects for eachdiagnosis for the three groups of OM, NM andFM. Since most studies which had found significant associations had identified FM days asbeing particularly important, t-tests were conducted comp aring mean numbers of patientsfor the three d iagnoses between FM andOM+NM days.RESULTSIn the prospective case-series for 1997,a total of228 new cases recorded in the IPHBoutpatients department, of these 18% had specific psychiatric disorders of interest in this study(0.9% mania, 6.5% depression, 10.8% non-affective psychotic episode). In the retrospectivecase-note survey for 1993, a total of 2346 newcases were recorded; of these 19% had specific psychiatric disorders of interest in this study(1.8% mania; 6.6% depression, 10.7% non-affective psychotic episode).

Relationship between diagnoses and FM,NM and OM days (Table 1) : No significant associations were found between the diagnosesof mania and depression and the lunar cycle ineither 1993 or 1997. However, a trend was discovered for greater number of diagnoses of non-affective psychotic disorders in FM and NMdays as compared to OM days in 1997. Thistrend was found to be even stronger in 1993where the re l a t i onsh ip was s ta t i s t i ca l l ysignificant.

Data were further analysed comparingFM days with all other days (i.e. OM and NMcombined). Aga in, while there was no differencein mean numbers of cases for depression andmania, mo re than twice the num ber of cases ofnon-affective psychoses were recorded on FMdays.This excess was highly significant fo r 1993(Table 2).Relat ionship between diagnoses andeclipses : A total of 8 eclipses were recorded

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TABLE 1COMPA RISON OF MEAN NUMBERS OF SUBJECTS WITH NON AFFECT IVE PSYC HOSIS,DEPRESSION OR MANIA ON FM , NM, AND OM DAYS IN 1993 & 1997

1993

1997

NMean95 CI

NMean95 CI

OM360.1

0.06-0.14

F=19

0.050.02-0.07

F

ManiaNM

30.250.14-0.64

=1.6; p=1

0.070.09-0.2

=0.4; p=

FM3

0.230.04-0.49

0.190

0.000.0

0.66

OM1480.4

0.36-0.5

1370.3

0.290.44

DepressionNM

50.4

0.008-0.8

F=0.09; p=4

0.30.07-0.68

F=0.6; p=

FM3

0.20.03-0.4

=0.497

0.580.01-1.15

=0.5

OM2290.6

0.58-0.75

F=2270.60.5-0.69

F

^on-affectivepsychosesNM FM5 18

0.4 1.30.08- 0.8-0.8 1.96

5.8; p=0 .0038 12

0.6 10.1- 1.2-1.07 1.7

=1.2;p=0.2(OM =Othermoondays;FM = Full moon days;NM= Newmoondays; N=total number of subjects; 95 Cl= (95 confidenceintervals of mean)

TABLE 2COMPARISON OF MEANS OF DIAGNOSES OF PATIENTS SEEN ON FM VERSUSOTHER DAYS FOR NON-AFFECTIVE PSYCHOSES, MANIA AND DEPRESSION

1993Mean of FM versus NM+OMt-test, p value1997Mean of FM versus NM +OMt-test. p value

Non-affectivepsychoses

1.3vs066T=3.2, p=0.001

1 0vs0 .6T=1.6. p=0.1

Mania

0.2vs0.11T=1.18,p=0.2

0.0vs0.05T=0.8, p=0.4

Depression

0.8vs0.5T=1.2,p=0.2

0.58vs0.36T=1.1.p=0.2

(FM = Full moon days ; NM= New moon days; OM =Other moon)globally during the study years as shown in thetable 3.The key association between eclipses andadmission were : there was no relationship between solar eclipses and diagnostic groups.However, for lunar eclipses visible in Goa, anaverage of 2 new cases of non-affective psychoses were recorded w hich is nearly four times

the average figure for other days (0.6). Due tosmall numbers, it was not feasible to estimatethe statistical significance of this difference . Nosuch association was noted for lunar eclipseswhich were not visible in Goa. There were noassociations noted for other diagnoses andlunar eclipses.

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TABLE 3ECLIPSES IN 1993 & 19971993Type Partial solar Total lunar Partial solar Total lunarDate May2 June 4 Nov. 13 Nov. 29Whether visible in Goa No Yes No No1997Type Partial solar Partial lunar Partial solar Total lunarDate March 9 March 24 Sept. 1-2 Sept. 16

Whether visible in Goa No No No YesD I S C U S S I O N

The objective of the study described inthis paper was to examine the relationship between mean numbers of new cases with thediagnoses of mania, depression or non-affective psychoses and the lunar cycle in a tertiarypsychiatric hospital population in Goa . The mainfinding of this study is the association of non-affective psychoses with ful l moon days. Thisexcess was even more significant for the twovisible lunar eclipse days.

W e b elieve that our findings suggest thatwhile the total number of admissions may notbe influenced by the lunar phase, those of thespecific diagnostic group of non affective psychoses may be uniquely influencd by the fullmoon and lunar eclipses. Indeed, in our datasample, there was no significant associationbetween total daily attendances or admissionrates with the lunar cycle. Advocates of the lunar hypothesis have attempted to link phasesof moon to a number of environmen tal factors,in principal, gravity and charged particles & electromagnetic forces (Rotten & Kelly, 1985). Themoon,via the effects of its gravitational forceson the human orga nism, causes cyclic changesin water flow among the fluid compartments ofthe body, as well as changes in total body waterresulting in what might be terme d biologicaltides . These change s, togetherwithassociatedelectrolyte and hormonal shifts, may set the

stage for d i f ferent ia l thresholds of neuralconstitutionally predisposed individuals, to moreor less severe emotional disturbance (Lieber &Sherin,1972). De Castro &P ea rcey (1995) statethat the lunar effect on grav ity is strongest whensun, earth and moon are in alignment duringthe newandfull moon phases and weakest whenthe sun, earth and moon form a right triangle.This study found that the rate of non-affectivepsychoses was even greater on lunar eclipsedays as compared to other ful l moon days; thisposes the question of the reason for this finding. On a examination of the lunar phases, itwas found that both the lunar eclipses hadoccurred on perigees, i.e. days when the moo nis closest to the earth. Being closer, it is possible that the gravitation al force induced must begreater. But when the perigee coincided w ith thenew moon, a similar increase was not found,making the possibility of a gravitational pull effect unl ikely. The l i terature mentions thatcharged particles emanating from the sun couldbe one of causes of behavioura l change s (Kay,1994) and the pull on these ch arged p articles ismore when the moon and earth are in line withthe su n. If the sun , via the charged particles, isthe cau se, then when earth is closer to the sunthere should be more charged particles in theatmosphere and a higher incidence of psychoticcases comb ining both the years (1997 and 1993)and averaging, the data of a one m onth p eriod,

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following the earth's perihelion (closest distanceto sun) showed a greater number of cases ofpsychoses (n=2 3.5), than the one m onth periodthat followed earth's aphelion (Farthest distancefrom sun) (n=14.5). Raps & Stoupel (1992) reported significant correlations between monthlynumbers of f irst psychiatric admissions withpositive solar radio flux and with sudden magnetic disturbances of the ionosphere. The m aincause of geomagnetic storms is a sudden increase in charged particles em anating fromsolar flares. The sun spot activity goes throug hcycles of 11.1 years. Thus the amount ofcharged particles in the environment also follows a cyclic rhythm . The pull on these chargedparticles towards the earth will be maximumwhen the earth and the moon are in alignmentduring the new and full moon as compared tothe other days of the moon. However the newmoon must be obstructing a sufficient amountof these charged particles from reaching theearth. This could be the reason for the lesserdegree significance of data on a new moon ascompared to that on full moon . And the sun viai ts charged part ic les produces changes ingeomagnetic flux which in turn is the cause ofthe higher incidence of psychotic illness.

The Key limitations of this study are thatit combines two different types of data collect ion, i.e. prospective and retrospective (basedon history sheets, which may have introduceda bias). Further, given the nature of the lunarcalendar, two years may be limited a period toobtain longitudinal trends or replicate findingsover different years.Some authors have advocated that research into possible links between lunar phasesand human behaviour is not worth pursuing (Rotten and Kelly, 1985 ). This view is encouragedby unsubstantiated assertion and speculationabout the cause of any effect. We consider thatfurther investigation may be justified and thatdisregarding this field of enquiry because it isreplete with myths is an understandable but inappropriate scientific response. We wouldsuggest replication of similar study using a much

larger data of atleast of two sunspot activitycycles, to confirm the relationship between n on-affective psychosis & full mo on and the po tential mechanisms by looking in more detail atpsychiatric disorders at the time of apoge es,perigees, aphelions and perihelions.ACKNOWLEDGEMENTS

We would like to thank the nursing staffand servants in helping collect the data. Than ksgoes to Dr. Ajoy Estibeiro and Association ofFriends of Astronomy for valuable suggestions.REFEREN ES

Al on so , Y. (1993) Geophysical variables andbehaviour : Barometric pressure, lunar cycle andtraffic accidents. Perceptual and Motor Skills, 77,371-376.Ast ro -Research Bureau (1993 ,1997)Indian Ephemeris of Planets posit ions. Calcutta.Lahiri.Bauer, S.F. & Hornic, E.J. (1968) Lunar effect on mental i l lness. The relat ionship of moon

phase to psychiatric emergencies. American Jour-nal of Psychiatry,125, 696-697.de-Cast ro , J .M. & Pearcey, S .M. (1995)Lunar rhythm of the meal and alcohol intake of humans. Physiology and Behaviour, 57, 439-444.Hicks-Caskey, W.E. & Potter, D.R. (1991)Effect of the full moon on a sample of developmen-tally delayed, institutionalised women. Perceptualand Motor Skills,72, 1375-1380.Kay, R.W. (1994) Geomagnetic storms : Association with incidence of depression as measured

by hospital admission. British Journal of Psychiatry,164, 403-404.Laverty,W.H.,Kelly,I.W. & Fly nn ,M. (1992)Geophysical variables and behaviour : Distal andlunar variables and traffic accidents in Saskatchewan 1984-1989. Perceptual and Motor Skills, 74,483-488Lieber, A.L. & Sher in, C.R. (1972) Homicides and the lunar cycle : toward a theory of lunarinfluence on human emotional disturbance. American Journal of Psychiatry, 129,69-74.

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LUNAR PHASE AND PSYCHIATRIC ILLNESS IN GOA

Lilienfeld,D.M.

Lunar Phase and Psychiatric Illness in Goa - Parameshwaran Ramakrishnan - Indian Journal of Psychiatry 1999, 41 (1), 60-65

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