The Transylvania effect refers to a concept that suggests a correlation between the lunar cycle and human behavior. Within this framework, violent behavior, suicide attempts, criminal activity, injuries, and accidents are the most prominent circumstances that have been investigated, with claims that such events are exacerbated during particular lunar phases (Gokhale and Kumar, Cureus, 2023; 15[11]). A lunar month lasts approximately 29.5 days and progresses through eight distinct synodic phases: new moon, waxing crescent, first quarter, waxing gibbous, full moon, waning gibbous, last quarter, and waning crescent.

This study aims to examine whether psychiatric emergencies vary according to lunar phases. To address this objective, psychiatric presentations were categorized into five groups. The specific aims were: 1)To determine the annual number of psychiatric presentations to the emergency department over an eight-year period 2) To classify the total number of presentations according to the eight synodic phases 3) To investigate potential associations between psychiatric diagnostic groups and lunar phases.

A total of 4,488 patients who presented to the Emergency Department of Kütahya Health Sciences University with psychiatric complaints between January 1, 2016, and October 24, 2024, were retrospectively evaluated in relation to the lunar phase at the time of presentation. Eligible patients were categorized into the following groups: suicide attempts, psychotic or manic episodes, anxiety or panic attacks, alcohol/substance withdrawal or intoxication, and other psychiatric conditions. Statistical analyses were performed using Poisson regression and negative binomial regression.

An increase was observed in suicide attempts, psychotic-manic episodes, anxiety-panic attacks, and total psychiatric emergency visits during the new moon and full moon phases. Regression analyses were conducted to confirm statistical significance. For this analysis, the new moon and full moon phases were compared against the remaining lunar phases. These remaining phases were grouped into a four-phase model consisting of new moon, waxing moon, full moon, and waning moon. Compared to the waning moon phase, the total number of psychiatric emergency presentations was significantly higher during both the full moon and new moon phases (p < 0.001 for each).Image 1:

The Transylvania effect, often regarded as a folkloric or mystical phenomenon, appears to influence psychiatric emergency presentations in this study. The new moon and full moon phases were associated with significant increases in total psychiatric emergencies, suicide attempts, and psychotic-manic exacerbations. Although much of the current literature disputes the existence of the Transylvania effect, these findings, derived from a large sample size, provide evidence that challenges prevailing skepticism.

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