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Cited by 118Climate Change and Health ImpactsPosttraumatic Stress Disorder ResearchMental Health Treatment and Access

Climate change, climate-related disasters and mental disorder in low- and middle-income countries: a scoping review

Open access
Sharpe, Isobel, Davison, Colleen M·2021·BMJ Open
DOI 10.1136/bmjopen-2021-051908PMC PMC8522671
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Abstract

Introduction: Climate change and climate-related disasters adversely affect mental health. Low- and middle-income countries (LMICs) are particularly vulnerable to the impacts of climate change and climate-related disasters and often lack adequate mental healthcare infrastructure. We used the scoping review methodology to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among those living in LMICs. We also aimed to recognise existing gaps in this area of literature. Methods: This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. To identify relevant studies, we searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo and Sociological Abstracts) from 1 January 2007 to 31 December 2019. We also searched the grey literature. Included studies had an adult-focused LMIC population, a climate change or climate-related disaster exposure and a mental disorder outcome. Relevant study information was extracted and synthesised. Results: Fifty-eight studies were identified, most of which (n=48) employed a cross-sectional design. The most commonly studied exposure–outcome combinations were flood-related post-traumatic stress disorder (PTSD) (n=28), flood-related depression (n=15) and storm-related PTSD (n=13). The majority of studies identified a positive exposure–outcome association. However, few studies included a baseline or comparator (ie, unexposed) group, thereby limiting our understanding of the magnitude or nature of this association. There was also great heterogeneity in this literature, making studies difficult to pool or compare. Several research gaps were identified including the lack of longitudinal studies and non-uniformity of geographic coverage. Conclusion: To our knowledge, this was the first scoping review to investigate the relationship between climate change and climate-related disaster exposures and mental disorder outcomes in LMICs. Our findings support the need for further research, but also highlight that mental health should be a priority within LMIC climate change policy considerations.

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review synthesised 58 studies on climate change and climate-related disaster exposures and mental disorder outcomes in low- and middle-income countries (LMICs), finding mostly positive exposure–outcome associations. It highlights major gaps, especially few unexposed comparator groups, limited longitudinal research, and uneven geographic coverage.

Key findings

  • Fifty-eight studies were included, spanning 11 countries; most were cross-sectional (n=45 cross-sectional; n=3 repeated cross-sectional), with fewer prospective cohort (n=5), ecological (n=4) and case-crossover (n=1) designs.
  • The most commonly studied exposure–outcome combinations were flood-related PTSD (n=28), flood-related depression (n=15), storm-related PTSD (n=13), flood-related anxiety (n=11) and storm-related anxiety (n=10).
  • The majority of studies identified a positive exposure–outcome association, but few included a baseline or comparator unexposed group, limiting understanding of the magnitude or nature of the association.
  • Research gaps included lack of longitudinal studies and non-uniform geographic coverage; no studies were conducted in South America or Africa, and most studies were concentrated in southern and eastern Asia.

Methods

  • Scoping review following PRISMA-ScR, Arksey and O’Malley framework, and Joanna Briggs Institute Reviewer’s Manual; conducted May 2020–March 2021.
  • Searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo, Sociological Abstracts) from 1 January 2007 to 31 December 2019, plus grey literature, manual journal searches, and backward/forward snowballing.
  • Included primary studies with adult-focused LMIC populations, a climate change or climate-related disaster exposure, and a mental disorder outcome evaluated based on DSM or ICD symptoms; data were extracted and synthesised qualitatively with tables, frequency counts and diagrams.

Limitations

  • The review was limited to English-language studies, excluding 23 non-English studies at full-text stage, and excluded sources published before 2007.
  • A single reviewer performed the initial relevancy screen of all records, though two independent reviewers screened remaining records at title/abstract and full-text stages.
  • The authors report substantial variation in study quality, with some studies providing little information on sampling, measurement tools and/or statistical analysis; they also note that few included studies had baseline/comparator groups, limiting conclusions about the association.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2021-051908

Cites

103 of 103 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 64 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Of those studies with an unexposed group, the majority identified a significant positive association between climate change or climate-related disaster exposures and mental disorder outcomes.

    “Of those studies with an unexposed group, the majority identified a significant positive association between climate change or climate-related disaster exposures and mental disorder outcomes.”
    Quote in the paperSubstantial claim
  • Findingown data

    The majority of included studies identified a positive exposure-outcome association.

    “The majority of studies identified a positive exposure–outcome association.”
    • Also stated in: § Discussion · plain
      “Overall, we observed a positive exposure–outcome relationship.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Greater composite exposure was identified as a risk factor for mental disorders in studies without a baseline/comparator group.

    “Greater composite exposure (ie, a sum of relevant individual exposures, for example, death/injury of loved ones, material loss, fear of death and loss of property).38 46”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [38] Dar, 2018, PTSD and depression in adult survivors of flood fury in Kashmir: the payoffs of social support, Psychiatry Res source

      Not checked in the free run.

    • cites [46] Chung, 2014, Posttraumatic stress disorder and psychiatric comorbidity following the 2010 flood in Pakistan: exposure characteristics, cognitive distortions, and emotional suppression, Psychiatry source

      Not checked in the free run.

  • Findingnone given

    There was great heterogeneity in this literature.

    “There was also great heterogeneity in this literature”
    Quote in the paperSubstantial claim
  • Findingnone given

    To the authors' knowledge, this was the first scoping or systematic review to assess how exposure to climate change and climate-related disasters influences mental disorders among those living in low- and middle-income countries.

    “To our knowledge, this was the first scoping review to investigate the relationship between climate change and climate-related disaster exposures and mental disorder outcomes in LMICs.”
    • Also stated in: § Conclusion · hedged
      “To our knowledge, this was the first scoping or systematic review to assess how exposure to climate change and climate-related disasters influences the presence of mental disorders among those living in low- and middle-income countries.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 17
  • Classified as probably not a substantial claim. 30
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingreasoning

    Several research gaps were identified, including the lack of longitudinal studies and non-uniformity of geographic coverage.

    “Several research gaps were identified including the lack of longitudinal studies and non-uniformity of geographic coverage.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The five most popular exposure-outcome combinations were PTSD in a flood setting (n=28), depression in a flood setting (n=15), PTSD in a storm setting (n=13), anxiety in a flood setting (n=11) and anxiety in a storm setting (n=10).

    “The five most popular combinations were post-traumatic stress disorder (PTSD) in a flood setting (n=28), depression in a flood setting (n=15), PTSD in a storm setting (n=13), anxiety in a flood setting (n=11) and anxiety in a storm setting (n=10).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    PTSD outcomes were reported most often, followed by depression and anxiety.

    “PTSD outcomes were reported the most often, followed by depression and anxiety.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The included countries spanned 4 of the 19 United Nations subregions.

    “The included countries spanned 4 of the 19 United Nations (UN) subregions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Of studies reporting, length of follow-up ranged from 3 weeks to 17 years, and most (n=30) followed up within a year.

    “Of those studies reporting, length of follow-up ranged from 3 weeks to 17 years. Most (n=30) studies followed up within a year.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    No studies were identified through the grey literature search.

    “No studies were identified through the grey literature search.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    A total of 10,200 records were identified through the electronic database searches.

    “A total of 10 200 records were identified through the electronic database searches.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most (91%) studies investigated the effects of climate-related disasters on mental disorder (direct effects), while fewer (9%) investigated the broader effects of climate change on mental disorder (indirect effects).

    “Most (91%) studies investigated the effects of climate-related disasters on mental disorder (direct effects), while fewer (9%) investigated the broader effects of climate change on mental disorder (indirect effects).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Flood exposures were the most studied, followed by storms and extreme temperatures.

    “Flood exposures were by far the most studied. The next most popular exposure was storms (including typhoons, hurricanes and snowstorms), followed by extreme temperatures.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The most commonly studied exposure-outcome combinations were flood-related PTSD (n=28), flood-related depression (n=15) and storm-related PTSD (n=13).

    “The most commonly studied exposure–outcome combinations were flood-related post-traumatic stress disorder (PTSD) (n=28), flood-related depression (n=15) and storm-related PTSD (n=13).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Included studies varied in outcome measurement, with some using formal diagnostic tools based on DSM or ICD and others using validated screening instruments to establish an informal diagnosis.

    “Some studies used formal diagnostic tools based on the DSM or ICD,41 76 92 while others used validated screening instruments to establish an informal diagnosis.35 36 52”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [41] Bhat, 2018, Socio-Demographic profile and psychiatric morbidity of flood victims in a mental health cAMP, J Psychiatry source

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    • cites [35] Bandla, 2019, Psychiatric morbidity in December 2015 flood-affected population in Tamil Nadu, India, Int J Soc Psychiatry source

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    • cites [52] source

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  • May combine two claims.

    Findingown data

    Nearly every included study presented mental disorder prevalence estimates, which ranged from 0.1% to 100%.

    “nearly every study presented mental disorder prevalence estimates, which ranged from 0.1% to 100%”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.

    “This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.”
    • Also stated in: § Methods · plain
      “The review took place between May 2020 and March 2021 and followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist23 as well as recommendations from the Arksey and O’Malley24 framework and the Joanna Briggs Institute (JBI) Reviewer’s Manual.25”
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    • cites [23] source

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    • cites [24] source

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    • cites [25] Peters M , Godfrey C , McInerney P . Chapter 11: Scoping Reviews (2020 version). In: Aromataris E , Munn Z , eds. Joanna Briggs Institute Reviewer’s Manual. JBI, 2020. https://reviewersmanual.joannabriggs.org/ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    There has been no review of recent literature on this topic published within the past 5 years.

    “Additionally, although this field of research is rapidly growing, there has been no review of recent literature published within the past 5 years.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The review searched five electronic databases and the grey literature.

    “To identify relevant studies, we searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo and Sociological Abstracts) from 1 January 2007 to 31 December 2019. We also searched the grey literature.”
    • Also stated in: § Information sources and search strategy · plain
      “To capture all relevant records, both electronic databases and the grey literature were searched.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Similar reviews have identified comparable trends.

    “Notably, similar reviews have identified comparable trends.19 93”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] source

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    • cites [93] source

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    Premisecitation

    Indirect impacts involve mental health problems associated with broader climate change-related events such as gradual temperature increase and displacement.

    “Indirect impacts involve mental health problems associated with broader climate change-related events such as gradual temperature increase and displacement. For example, rising sea levels may contribute to population displacement, resulting in mental health problems associated with overcrowding and poverty.12 13”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] Shultz, 2019, Public health and mental health implications of environmentally induced forced migration, Disaster Med Public Health Prep source

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    • cites [13] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The database search strategy was designed in consultation with a health sciences librarian.

    “The database search strategy was designed in consultation with a health sciences librarian, first developed in MEDLINE and subsequently translated to the other databases.”
    Quote in the paperNot a substantial claim

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    Premisecitation

    In 2010, mental, neurological and substance abuse disorders accounted for 10.4% of all disability-adjusted life-years globally.

    “In 2010, mental, neurological and substance abuse disorders accounted for 10.4% of all disability-adjusted life-years globally.21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] source

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  • May combine two claims.

    Premisecitation

    Low- and middle-income countries are particularly vulnerable to the impacts of climate change and climate-related disasters and often lack adequate mental healthcare infrastructure.

    “Indeed, those living in low- and middle-income countries (LMICs) disproportionately suffer from the negative effects of climate-related disasters and from broader environmental changes such as reduced crop yields.15 16 LMICs also commonly lack adequate infrastructure for mental health services.17 18”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [15] Wirtz A . Natural disasters and the insurance industry. In: Guha-Sapir D , Santos I , Borde A , eds. The economic impacts of natural disasters. New York, NY: Oxford University Press, 2013: 128–53. source

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    • cites [16] source

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    • cites 17 18

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Study design and conductown data

    Two independent reviewers screened titles/abstracts and full texts for eligibility.

    “Next, the titles/abstracts of each remaining record were screened by two independent reviewers and those deemed irrelevant were excluded.”
    • Also stated in: § Screening · plain
      “The remaining studies were screened for eligibility at the full-text level by two reviewers.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The review was limited to English-language studies only.

    “Owing to project feasibility, our review was limited to English-language studies only.”
    • Also stated in: § Eligibility criteria · plain
      “Additionally, for feasibility reasons only English-language studies were included.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Rataj et al and Crabtree conducted systematic searches on the direct negative mental health impacts of climate-related weather events in developing countries but did not explore the indirect impacts of climate change on mental health.

    “Rataj et al19 and Crabtree20 conducted systematic searches on the direct negative mental health impacts of climate-related weather events in developing countries; however, they did not explore the indirect impacts of climate change on mental health.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [19] source

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    • cites [20] Crabtree, 2012, Climate change and mental health following flood disasters in developing countries, a review of the epidemiological literature: what do we know, what is being recommended?, Australas J Disaster Trauma Stud

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The data extraction form was piloted on a random sample of five studies and adjusted accordingly.

    “Prior to beginning the extraction process, the form was piloted on a random sample of five studies and adjusted accordingly.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    We limited our search to exclude sources published before 2007.

    “we limited our search to exclude sources published before 2007”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Rataj et al and Crabtree reviewed the mental health impacts of climate-related weather events in developing countries, but did not evaluate the broader, indirect impacts of climate change.

    “While Rataj et al19 and Crabtree20 reviewed the mental health impacts of climate-related weather events in developing countries, they did not evaluate the broader, indirect impacts of climate change”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Rataj et al19

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    • cites Crabtree20

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Screening instruments are an important tool for assessing the presence of mental disorders in LMIC settings, where healthcare workers may not be qualified or may not have time to administer complex diagnostic interviews.

    “Screening instruments are an important tool for assessing the presence of mental disorders in LMIC settings, where healthcare workers may not be qualified or may not have time to administer complex diagnostic interviews.103”
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    • cites [103] source

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    Premisecitation

    Others have discussed the utility of longitudinal designs for capturing changes in mental health over time against climate change and climate-related disaster exposures.

    “Others have discussed the utility of longitudinal designs for capturing changes in mental health over time against climate change and climate-related disaster exposures.27 96”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] source

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    • cites [96] Berry, 2018, The case for systems thinking about climate change and mental health, Nat Clim Chang source

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    Premisecitation

    The IPCC identified Africa as one of the regions most vulnerable to climate change.

    “the IPCC identified Africa as one of the regions most vulnerable to climate change.100”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [100] Niang I , Ruppel OC , Abdrabo MA . Africa. In: Barros VR , Field CB , Dokken DJ , eds. Climate change 2014: impacts, adaptation, and vulnerability. Part B: regional aspects. contribution of working group II to the fifth assessment report of the Intergovernmental panel on climate change. Cambridge, UK and New York, NY: Cambridge University Press, 2014: 1199–265. https://www.ipcc.ch/report/ar5/wg2/africa/

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The substantial methodological heterogeneity is likely related to the emergency and under-resourced settings in which many of these studies took place.

    “likely related to the emergency and under-resourced settings in which many of these studies took place”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    23 non-English studies were excluded at the full-text stage.

    “23 non-English studies were excluded at the full-text stage”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In a global context, Neria et al reported PTSD prevalence estimates ranging from 3.7% to 60% at 1-2 years post disaster.

    “In a global context, Neria et al95 reported PTSD prevalence estimates ranging from 3.7% to 60% at 1–2 years post disaster”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Neria et al95

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Data from the World Mental Health survey showed that of those experiencing suicidality in high-, middle- and low-income countries, 56%, 28% and 17% sought treatment in the past 12 months, respectively.

    “Data from the World Mental Health survey showed that of those experiencing suicidality in high-, middle- and low-income countries, 56%, 28% and 17% sought treatment in the past 12 months, respectively.99”
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    • cites [99] source

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    Premisecitation

    Use of a single reviewer can be suboptimal in some scenarios.

    “Although evidence suggests that use of a single reviewer can be suboptimal in some scenarios,105”
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    • cites [105] source

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    Premisecitation

    Other systematic reviews have identified comparable proportions of cross-sectional studies.

    “Other systematic reviews have identified comparable proportions of cross-sectional studies.19 20”
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    • cites [19] source

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    • cites [20] Crabtree, 2012, Climate change and mental health following flood disasters in developing countries, a review of the epidemiological literature: what do we know, what is being recommended?, Australas J Disaster Trauma Stud

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  • May combine two claims.

    Premisecitation

    The IPCC's fourth assessment report was published in 2007, in which the authors first acknowledged the impacts of climate change on human health and well-being.

    “the IPCC’s fourth assessment report was published in 2007, in which the authors first acknowledged the impacts of climate change on human health and well-being.27”
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    • cites [27] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In a global meta-analysis, Beaglehole and colleagues reported a significant increase in postnatural disaster mental disorder outcomes (OR 1.84, 95% CI 1.43 to 2.38, p<0.001, n=6 studies).

    “For example, in a global meta-analysis Beaglehole and colleagues93 reported a significant increase in postnatural disaster mental disorder outcomes (OR 1.84, 95% CI 1.43 to 2.38, p<0.001, n=6 studies).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [93] source

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    Premisecitation

    Beaglehole et al conducted a systematic review and meta-analysis of psychiatric disorders and psychological distress after natural disasters, but included disasters likely unrelated to climate change and were not LMIC-focused.

    “Beaglehole et al93 conducted a systematic review and meta-analysis of psychiatric disorders and psychological distress after natural disasters; however, they included disasters likely unrelated to climate change and were not LMIC-focused”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Beaglehole et al93

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  • May combine two claims.

    Study design and conductreasoning

    Two independent reviewers completed the study screening, thereby reducing bias in the evidence selection process.

    “As per these standards, two independent reviewers completed the study screening, thereby reducing bias in the evidence selection process”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The review was conducted in accordance with recommendations from the Arksey and O'Malley framework, PRISMA-ScR checklist and JBI Reviewer's Manual.

    “we conducted the review in accordance with recommendations from the Arksey and O’Malley framework, PRISMA-ScR checklist and JBI Reviewer’s Manual, three widely used standards supporting the execution of a high-quality review”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Due to the large volume of studies returned by the electronic database search (6971 unique records), we conducted a single-author relevancy screen of all records as the first screening stage.

    “due to the large volume of studies returned by the electronic database search (6971 unique records), we conducted a single-author relevancy screen of all records as the first screening stage”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    We included English-language studies only.

    “we included English-language studies only”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    This review supports the need to address mental health as a priority in future climate change action.

    “Overall, this review supports the need to address mental health as a priority in future climate change action”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Those living in LMICs are particularly vulnerable to the effects of climate change and climate-related disasters and also lack adequate mental health supports.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The findings of this review support the consideration of mental health within LMIC climate change policy.

    “The findings of this review support the consideration of mental health within LMIC climate change policy”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Those living in LMICs are particularly vulnerable to the effects of climate change and climate-related disasters and also lack adequate mental health supports.
44 of 44

  • The paper relies on this without support.

    Those living in LMICs are particularly vulnerable to the effects of climate change and climate-related disasters and also lack adequate mental health supports.

    “Those living in LMICs are particularly vulnerable to the effects of climate change and climate-related disasters and also lack adequate mental health supports”

  • The paper relies on this without support.

    Particularly in LMICs, infrastructure may not be present to support costly and time-consuming data collection efforts.

    “Particularly in LMICs, infrastructure may not be present to support costly and time-consuming data collection efforts”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Typhoon Xangsane study placed in two countries

    Minor

    The discussion places Amstadter et al's study of Typhoon Xangsane in the Philippines, but the results section says Xangsane hit Vietnam and describes the study in its Southeast Asia discussion of Vietnam.

  • PTSD prevalence described as stable despite nearly doubling

    Minor

    The reported PTSD prevalence rises from 10.6% at 2 months to 20.5% at 2 years, which conflicts with the statement that prevalence of both disorders remained relatively stable.

2 of 2

Cites

Flagged first, then by citations

1 of the 104 references couldn’t be matched to a known paper.

Research works printed but not linked: 11

  1. Grimshaw J . A guide to knowledge synthesis: a knowledge synthesis chapter. Canadian Institutes for health research, 2010. Available: https://cihr-irsc.gc.ca/e/41382.html [Accessed 5 Nov 2020].
  2. Idris, 2018, Mental health disorder among post flood victims in Pahang, ASEAN J Psychiatry, 19, 1
  3. Akhtar, 2017, Depression among Thari women due to drought at Bodhesar village Nagarparkar Thar, Eur J Med Res, 22
  4. Nasar, 2016, Stress reaction and post-traumatic stress disorder among flood victims of Lahore- Pakistan and role of community (ROC), Int J Psychosoc Rehabil, 20, 75
  5. Qazi, 2014, The prevalence of major depression in a rural flood affected area of Pakistan, Pak J Med Health Sci, 8, 249
  6. Rahman, 2013, Psychological effects among internally displaced persons (IDPS) residing in two districts of Sindh, Med Forum Mon, 24, 82
  7. Yoda, 2013, Mental health research for the 2011 flood affected people in Thailand, Trop Med Int Health, 18, 196
  8. Rasdi, 2016, The association between KAP on disasters with depression, GAD and PTSD among flood victims, Indian J Environ Prot, 36, 888
  9. Xiong, 2016, Prevalence of post traumatic stress disorder (PTSD) among flood victims in Malaysia: difference between Kuala Lumpur and Kelantan, Int Med J, 23, 114
  10. 10.1017/s003329-1707001353 · DOI
  11. Niang I , Ruppel OC , Abdrabo MA . Africa. In: Barros VR , Field CB , Dokken DJ , eds. Climate change 2014: impacts, adaptation, and vulnerability. Part B: regional aspects. contribution of working group II to the fifth assessment report of the Intergovernmental panel on climate change. Cambridge, UK and New York, NY: Cambridge University Press, 2014: 1199–265. https://www.ipcc.ch/report/ar5/wg2/africa/

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Authors
Sharpe, I., & Davison, C. M.
Affiliations
Queen's University (CA)
Corresponding author
Davison, Colleen M
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2021-10
Volume
11
Issue
10
Pages
e051908
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2021-051908
PMC
PMC8522671
OpenAlex
W3207767416
Semantic Scholar
dd0f2c589da9dcded964606a38639620a5c58293
Cited by
118
References
104
Citations by year
2026: 23 · 2025: 27 · 2024: 33 · 2023: 23 · 2022: 11 · 2021: 1
FWCI
1.63
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Social Sciences and Humanities Research Council (435-2019-1083)
  • Canadian Institutes for Health Research (PJT-162463, PJT-165971)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
climate change, climate-related disasters, mental illness, post-traumatic stress disorder, depression, floods, storms, low- and middle-income countries, mental health policy, disaster exposure
MeSH terms
Adult, Cross-Sectional Studies, Developing Countries, Disasters, Humans, Stress Disorders, Post-Traumatic, Climate Change

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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