Objectives: This study investigated the association between surrounding greenness and bipolar disorder in the Taipei metropolitan area (Taipei City and New Taipei City) using a geographic information system and remote sensing technologies. Methods: The seasonal incidence of bipolar disorder from 2003 to 2012 for each township in the Taipei metropolitan area was calculated based on medical records extracted from the Longitudinal Health Insurance Database 2000. Surrounding greenness information was collected as the normalized difference vegetation index (NDVI) provided by NASA's Moderate Resolution Imaging Spectroradiometer. The generalized additive mixed model was applied to examine the relationship between surrounding greenness and bipolar incidence after adjusting for socioeconomic status, demographic characteristics, environmental factors, and comorbidity. Results: Accounting for potential confounding variables, we found a statistically significant negative relationship between NDVI and bipolar incidence (regression coefficient: -0.51; 95% confidence interval [CI]: -0.68, -0.48; /><0.01). The adjusted relative risk for bipolar incidence was 0.60 (95% CI: 0.51-0.71) per interquartile range increment (0.33) on NDVI. Conclusions: Surrounding greenness is statistically associated with bipolar incidence in the Taipei metropolitan area. (Taiwan J Public Health. 2018 ;37(5) :514-526).
All Science Journal Classification (ASJC) codes