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Cited by 154Climate Change and Health ImpactsMental Health Treatment and AccessClimate Change Communication and Perception

The effects of climate change on mental health

Open access
Walinski, Annika, Sander, Julia, Gerlinger, Gabriel, Clemens, Vera, Meyer-Lindenberg, Andreas, Heinz, Andreas·2023·Deutsches Ärzteblatt international
DOI 10.3238/arztebl.m2022.0403PMC PMC10154789
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Abstract

BACKGROUND: All over the world, climate change is exerting negative and complex effects on human living conditions and health. In this narrative review, we summarize the current global evidence regarding the effects of climate change on mental health. METHODS: A systematic literature search concerning the direct effects of acute extreme weather events (floods, storms, fires) and chronic stresses (heat, drought) due to climate change, as well as the indirect effects of climate change (food insecurity, migration), on the diagnoses of mental disorders, psychological distress, and psychiatric emergency admissions was carried out in PubMed and PsychInfo, and supplemented by expert selection. 1017 studies were identified, and 128 were included. RESULTS: The heterogeneity of study methods does not permit any overall estimate of effect strength. The available evidence shows that traumatic experiences due to extreme weather events increase the risk of affective and anxiety disorders, especially the risk of post-traumatic stress disorder. Heat significantly increases the morbidity and mortality attributable to mental illness, as well as the frequency of psychiatric emergencies. Persistent stressors such as drought, food insecurity, and migration owing to climate change can also be major risk factors for mental illness. CONCLUSION: The consequences of climate change are stress factors for mental health. Therefore, as global warming progresses, an increasing incidence and prevalence of mental illness is to be expected. Vulnerable groups, such as the (already) mentally ill, children, and adolescents, need to be protected. At the same time, there is a need for further systematic research on the mechanisms of action and effects of climate change on mental function.

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Crossref · 10.3238/arztebl.m2022.0403

Cites

98 of 98 references verified0 citation errors · 0 not checkable

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Claims the paper makes

30 of 90 cited sources checked · 13 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Climate change has made natural disasters and extreme weather events more frequent and intense.

    “climate change has nevertheless led to an increase in frequency and intensity of natural disasters and extreme weather events.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [2] Cianconi P, Betrò S, Janiri L: The impact of climate change on mental health: a systematic descriptive review. Front Psychiatry 2020; 11: 74. source

      The Introduction links warming to a global rise in the frequency and intensity of extreme weather events and reports increases in specific events. But it also says scientists have not fully linked climate change to the increase in extreme weather events, so the claim’s unqualified causal wording—and its broader reference to natural disasters—overstates the review. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [4] Hayes K, Blashki G, Wiseman J, Burke S, Reifels L: Climate change and mental health: risks, impacts and priority actions. Int J Ment Health Syst 2018; 12: 28. source
  • Premisecitation

    The harm and losses from climate change are an increasingly clear danger to human health.

    “The loss and damage caused (1) is becoming an increasingly palpable and visible threat to human health (2, 3).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [2] Cianconi P, Betrò S, Janiri L: The impact of climate change on mental health: a systematic descriptive review. Front Psychiatry 2020; 11: 74. source
    • cites [3] Clayton S: Climate change and mental health. Curr Envir Health Rep 2021; 8: 1–6. source
  • Premisecitation

    Children who tend to ruminate have a higher risk of depressive symptoms after a flood.

    “In particular, children prone to rumination have an increased risk of developing symptoms of depression after experiencing a flood (17).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [17] Felton JW, Cole DA, Martin NC: Effects of rumination on child and adolescent depressive reactions to a natural disaster: the 2010 Nashville flood. J Abnorm Psychol 2013; 122: 64–73. source

      The Discussion reports that preflood rumination correlated with postflood depressive symptoms. But its Conclusion specifies that rumination was a risk factor after the flood for adolescents, not children; the claim omits that age distinction. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
  • Premisecitation

    Adolescents and young adults with family dysfunction and other traumatic experiences are especially vulnerable.

    “Adolescents and young adults with family dysfunction and other traumatic experiences are particularly vulnerable (25,29).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [25] Robertson AA, Morse DT, Baird-Thomas C: Hurricane Katrina’s impact on the mental health of adolescent female offenders. Anxiety Stress Coping 2009; 22: 433–48. source

      The Discussion reports that family stressors and other traumatic events significantly affected anxiety and depression among high-risk adolescent female offenders after Hurricane Katrina. The Method describes participants aged 11–19; the paper does not establish the same vulnerability for young adults generally or for adolescents outside this study population. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [29] Yang P, Yen C-F, Tang T-C, et al.: Posttraumatic stress disorder in adolescents after Typhoon Morakot-associated mudslides. J Anxiety Disord 2011; 25: 362–8. source
  • Premisecitation

    In an Australian longitudinal study, childhood bushfire experience was linked to higher lifetime anxiety disorder prevalence 20 years later than in an unaffected control group (21.5% vs 16%, RR=1.37 [1.05;1.78], p<0.05).

    “An Australian longitudinal study showed that experiencing bushfires in childhood can be most stressful.In adulthood, 20 years later, the prevalence of lifetime anxiety disorder is greater than in an unaffected control group (21.5% versus 16%, relative risk [RR] = 1.37 [1.05; 1.78), p <0.05).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [35] McFarlane AC, Van Hooff M: Impact of childhood exposure to a natural disaster on adult mental health: 20-year longitudinal follow-up study. Br J Psychiatry 2009; 195: 142&#8211;8. source
  • May combine two claims. 39
  • Classified as probably not a substantial claim. 7

  • May combine two claims.

    Premisecitation

    The chance of post-traumatic symptoms and depression rises with exposure severity, especially with physical injury, death or serious injury of household members, low income, and storm-related property damage.

    “The likelihood of posttraumatic symptoms and depression increases with the severity of exposure, even more so in the case of physical injury, death or serious injury to household members, low income, and stormrelated property damage (22).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [22] Schwartz RM, Gillezeau CN, Liu B, Lieberman-Cribbin W, Taioli E: Longitudinal impact of hurricane Sandy exposure on mental health symptoms. Int J Environ Res Public Health 2017; 14: E957. source

      The Results (§3.3; page unavailable) associate greater personal and property exposure with PTSD symptoms at follow-up, supporting the post-traumatic-symptoms and property-damage portions. They find no association between exposure and depression symptoms. The paper does not establish that physical injury or death or serious injury of household members specifically increases either outcome; the Discussion (§4; page unavailable) discusses greater harm among low-income people as a finding from earlier studies, not this analysis. (LLM, conf=0.90)

      Experimental — accuracy not yet measured

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    Premisecitation

    Negative income development after a fire disaster can increase violence, especially against women, harming their mental health years later.

    “The negative income development in areas after a fire disaster can lead to increased violence, especially against women, resulting in negative effects on their mental health several years after the fire disaster (36).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [36] Molyneaux R, Gibbs L, Bryant RA, et al.: Interpersonal violence and mental health outcomes following disaster. BJPsych Open 2019; 6: e1. source

      The Results and Discussion report that negative income change was associated with higher odds of violence among women in highly bushfire-affected areas, and that violence was associated with PTSD and depression symptoms 3–4 years later. The Discussion explicitly says the cross-sectional data cannot establish whether income change caused violence or whether violence caused poorer mental health, so the citing sentence overstates these associations as causal. (LLM, conf=0.89)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Heat is linked to higher morbidity, more psychiatric emergencies, and a significantly higher risk of dying from mental disorders.

    “Heat is associated with increased morbidity, a surge in psychiatric emergencies, and a significantly increased risk of dying from mental disorders: Thus, the morbidity of mood disorders, organic mental disorders, schizophrenia, and neurotic and anxiety disorders increases with high outdoor temperatures and during heatwaves (39,40).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [39] Liu J, Varghese BM, Hansen A, et al.: Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. Environ Int 2021; 153: 106533. source
    • cites [40] Chen N-T, Lin P-H, Guo Y-LL: Long-term exposure to high temperature associated with the incidence of major depressive disorder. Sci Total Environ 2019; 659: 1016&#8211;20. source

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    Premisecitation

    A recent review found high prevalences of PTSD (15.6-60%), depression, and generalized anxiety in adults from three months to years after a wildfire or bushfire.

    “A recent review shows high prevalences of PTSD (15.6-60%), depression, and generalized anxiety in adults between the post-acute phase (three months) and up to years after a wildfire or bushfire (33) (Table 1, eTable 1).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [33] To P, Eboreime E, Agyapong VIO: The impact of wildfires on mental health: a scoping review. Behav Sci 2021; 11: 126. source

  • May combine two claims.

    Premisecitation

    Natural disasters and extreme weather events clearly affect human health and are used in research to measure climate change.

    “These are having a most obvious impact on human health and are used in the scientific literature to operationalize climate change (2,4).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [2] Cianconi P, Betrò S, Janiri L: The impact of climate change on mental health: a systematic descriptive review. Front Psychiatry 2020; 11: 74. source
    • cites [4] Hayes K, Blashki G, Wiseman J, Burke S, Reifels L: Climate change and mental health: risks, impacts and priority actions. Int J Ment Health Syst 2018; 12: 28. source

      The Background (‘Climate change and health’; page unavailable) reports extreme-weather-related morbidity and mortality, supporting the health-impact claim. The Discussion (‘Exploring the challenges and opportunities of attribution’; page unavailable) says many disaster mental-health studies treat extreme weather events as isolated natural disasters rather than connecting them to climate change. It therefore does not support the broader assertion that the literature uses those events to operationalize climate change. (LLM, conf=0.87)

      Experimental — accuracy not yet measured

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    Premisecitation

    When other traumatic experiences are added later to a childhood fire event, lifetime PTSD prevalence in children is higher (7.8% vs 5.8%, RR=1.80 [1.11;2.93], p<0.05), but not without this cumulative effect.

    “If other traumatic experiences are added to the fire event during further life, however, there is an increased prevalence of lifetime PTSD for children (7.8% versus 5.8%, RR = 1.80 [1.11; 2.93], p <0.05), but not without this cumulative effect (35).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [35] McFarlane AC, Van Hooff M: Impact of childhood exposure to a natural disaster on adult mental health: 20-year longitudinal follow-up study. Br J Psychiatry 2009; 195: 142&#8211;8. source

      The Discussion and the section ‘Lifetime and current PTSD in relation to the bushfire’ report greater PTSD risk among survivors who nominated a later event, rather than the fire, as their worst event. But Table 2 gives 7.8% versus 5.8% for all bushfire-exposed participants versus controls, with RR 1.36 (95% CI 0.84–2.19), p=0.21—not the significant RR and p-value attributed to those percentages. The claim conflates the subgroup finding with the nonsignificant whole-group comparison. (LLM, conf=0.91)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The main risk factor is the fire trauma itself; high fire exposure has a stronger mental health effect than low exposure.

    “The principle risk factor is the fire trauma itself, i.e., a high level of exposure to a fire has a stronger effect on mental health than a low level of exposure (34).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] Silveira S, Kornbluh M, Withers MC, Grennan G, Ramanathan V, Mishra J: Chronic mental health sequelae of climate change extremes: a case study of the deadliest californian wildfire. Int J Environ Res Public Health 2021; 18: 1487. source

      The Discussion reports significantly higher mental-health symptom scores among directly exposed participants, particularly for PTSD and depression, supporting the exposure comparison. But the Results (section 3.3) show that vulnerability and resilience factors substantially improved prediction, and fire exposure was not significantly associated with anxiety after those factors were included. The paper therefore does not establish fire trauma itself as the principal risk factor across mental-health outcomes. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

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

    Premisecitation

    Worldwide desert expansion has made adverse health effects from dust storms more frequent, with consequences similar to fine particulate air pollution.

    “The expansion of deserts worldwide has resulted in more frequent adverse health effects from dust storms, the consequences of which are similar to those of fine particulate air pollution (27).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [27] Lee H, Jung J, Myung W, et al.: Association between dust storm occurrence and risk of suicide: case-crossover analysis of the Korean national death database. Environ Int 2019; 133: 105146. source

      The Introduction (page unavailable) discusses increasing global desertification and identifies dust storms as health risks. It does not establish that desert expansion has made adverse health effects more frequent. The Introduction and section 4.2 discuss health effects associated with both dust storms and fine-particle air pollution, but section 4.2 cautions against directly comparing their suicide-risk estimates; the claimed similarity of consequences is therefore not established. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In children after wildfires and bushfires, increased rates of mental disorders were found: PTSD in the subacute phase 92%, depression after 18 months 33.3%, and anxiety disorder after 18 months 27%.

    “An increased rate of mental disorders (PTSD during the subacute phase after a wildfire: 92 %, depression after 18 months: 33.3 %, anxiety disorder after 18 months: 27 %) was also found after wildfires and bushfires in the child population of the mentioned review (33).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [33] To P, Eboreime E, Agyapong VIO: The impact of wildfires on mental health: a scoping review. Behav Sci 2021; 11: 126. source

      The Discussion reports that up to 92% of children had significant PTSD symptoms in the subacute phase (Section 4.1), one third of grade 7–12 students met criteria for depression at 18 months (Section 4.2), and 27% had suspected anxiety at 18 months (Section 4.3). The claim presents the PTSD-symptom and suspected-anxiety figures as rates of diagnosed disorders, which the review does not establish. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The main predictors of developing a mental health condition after a flood disaster are socioeconomic vulnerability, long-term displacement, persistent material damage, and insurance-related problems.

    “The main predictors of developing a mental health condition after a flood disaster are socioeconomic vulnerability, long-term displacement (7), persistent material damage (9), and insurancerelated problems (8) (eTable 1).”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [7] Matthews V, Longman J, Berry HL, et al.: Differential mental health impact six months after extensive river flooding in rural Australia: a cross-sectional analysis through an equity lens. Front Public Health 2019; 7: 367. source
      Experimental — accuracy not yet measured
    • cites [9] Mulchandani R, Armstrong B, Beck CR, et al.: The English National Cohort Study of Flooding &amp; Health: psychological morbidity at three years of follow up. BMC Public Health 2020; 20: 321. source
      Experimental — accuracy not yet measured
    • cites [8] Mulchandani R, Smith M, Armstrong B, English National Study of Flooding and Health Study Group, Beck CR, Oliver I: Effect of insurance-related factors on the association between flooding and mental health outcomes. Int J Environ Res Public Health 2019; 16: E1174. source
      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Tourists exposed to flooding who returned to an unaffected home country showed long-term PTSD symptoms, with severity depending on exposure.

    “However, tourists who had been exposed to flooding and then returned to an unaffected home country also demonstrated long-term symptoms of PTSD, depending of the severity of their exposure (13,14).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13] Heir T, Sandvik L, Weisæth L: Hallmarks of posttraumatic stress: symptom z-scores in a tsunami-affected tourist population. Psychopathology 2009; 42: 157&#8211;64. source
    • cites [14] Heir T, Rosendal S, Bergh-Johannesson K, et al.: Tsunami-affected Scandinavian tourists: disaster exposure and post-traumatic stress symptoms. Nord J Psychiatry 2011; 65: 9&#8211;15. source

  • May combine two claims.

    Premisecitation

    Loss of social support and socioeconomic decline are additional risk factors for depression and post-traumatic symptoms.

    “Other risk factors for depression and post-traumatic symptoms include loss of social support and socioeconomic decline (23)(24)(25)(26).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (23)(24)(25)(26)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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    Premisecitation

    Elderly people with dementia, rural community inhabitants, and indigenous populations are other vulnerable groups.

    “Other vulnerable groups are elderly people with dementia, inhabitants of rural communities, and indigenous populations (38).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Farugia TL, Cuni-Lopez C, White AR: Potential impacts of extreme heat and bushfires on dementia. J Alzheimers Dis 2021; 79: 969&#8211;78. source

  • May combine two claims.

    Premisecitation

    Few studies cover children and adolescents, but rising temperatures have been linked to worse mental health and more emergency department contacts for mental disorders in this group.

    “There are comparatively few studies available on children and adolescents.However, a deterioration of mental health and increase in emergency department contacts for mental disorders with rising temperatures was also demonstrated for this young group (e11-e14).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e11-e14)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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    Premisecitation

    Climate-induced destabilization of states, groups, and regions can lead to violent conflicts and wars, driving environmentally induced migration.

    “The destabilization of states, groups, and regions induced by climate change can lead to violent conflicts and wars, acting as a driver of environmentally induced migration (e30).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e30)

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  • May combine two claims.

    Premisecitation

    Heat is linked to more psychiatric emergencies and emergency admissions to psychiatric hospitals.

    “Heat is associated with increasing numbers of psychiatric emergencies and (emergency) admissions to psychiatric hospitals (e1, e2).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites (e1, e2)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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    Premisecitation

    Drought can cause food shortage and destruction or alteration of agricultural areas.

    “Not only can drought be the cause of food shortage and the destruction of, or alteration to, agricultural areas (e16)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e16)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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    Premisecitation

    Drought may increase family tension, emotional stress, and domestic or intimate-partner violence.

    “In addition, there is a potential for increased family tension, emotional stress, and domestic or intimate-partner violence (e16, e20, e21).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e16, e20, e21)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Women and the elderly are vulnerable groups with a particularly strong dose-dependent relationship between food insecurity and distress as well as mental disorders.

    “Other vulnerable groups include women and the elderly in whom a particularly strong dose-dependent relationship is evident between food insecurity and distress (e26, e27) as well as mental disorders (e28, e29).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites (e26, e27)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites (e28, e29)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Negative migration experiences and adjustment difficulties lower self-esteem, promote depressive symptoms, and increase suicide risk.

    “Negative experiences and difficulties in the adjustment process after migration also lower self-esteem, promote depressive symptoms, and increase the risk of suicide (e35).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e35)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Drought is linked to higher suicide rates; Australian long-term data showed a 15% higher suicide risk for rural middle-aged men as the drought index increased.

    “Drought is also associated with increased suicide rates.Australian long-term data revealed that, with increased values of the drought index, there was a 15% increased risk of suicide for rural middle-aged men (e17).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e17)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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    Premisecitation

    Malnutrition in children can impair neuronal development and increase risk of mental illnesses such as depression and ADHD.

    “Malnutrition in children can impair (neuronal) development, resulting in an increased risk of mental illnesses such as depression and attention deficit hyperactivity disorder (e23).”
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    • cites (e23)

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    Premisecitation

    A systematic review by Kien and colleagues reported point prevalences among children and adolescents of 19-52.7% for PTSD, 10.3-32.8% for depression, 8.7-31.6% for anxiety disorders, and 19.8-35% for emotional and behavioral problems.

    “In a systematic review, Kien and colleagues (2019) report of point prevalences of between 19% and 52.7% for PTSD, 10.3 to 32.8% for depression, 8.7 to 31.6 % for anxiety disorders, and 19.8 to 35% for emotional and behavioral problems (e37) (eTable 3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e37)

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  • May combine two claims.

    Premisecitation

    Direct and indirect, especially economic, drought effects promote depression, anxiety disorders, and increased alcohol and substance use.

    “The direct and indirect, and especially economical, effects of drought promote the development of depression and anxiety disorders as well as increased alcohol and substance use (e16).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites (e16)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Poor nutrition can impair cognition and cause mental symptoms including fatigue, lethargy, depression, manias, and psychoses.

    “Poor nutrition can impair cognition and also cause mental symptoms, such as fatigue, lethargy, depression, manias, and psychoses (e23, e24).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e23, e24)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Food insecurity in British families was associated with maternal depression, psychotic disorders, domestic violence, and behavioral problems in children.

    “Food insecurity in British families, for example, was associated with maternal depression, psychotic disorders, domestic violence, and behavioral problems in children (e25), see eTable 3 for details.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e25)

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  • May combine two claims.

    Premisecitation

    Availability of outpatient healthcare and green open spaces appears protective.

    “The availability of outpatient healthcare services and of green open spaces, on the other hand, appears to be a protective factor (e4).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e4)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Where possible, the synthesis is based on systematic reviews and on a selection of relevant publications and outcomes.

    “The synthesis of the findings is therefore based, where possible, on systematic reviews as well as on a selection of relevant publications and outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Uncertain residence status with restricted rights and integration difficulties are additional stressors during migration to a foreign country.

    “An uncertain residence status, with its associated restricted rights, and difficulties with integration are additional stress factors during migration to a foreign country (e44, e45).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e44, e45)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Stress, separation, loneliness, loss of identity, lack of belonging, and lack of supportive social networks and socioeconomic resources are significant mental health risk factors.

    “Stress, separation and loneliness, loss of identity, no sense of belonging, lack of social values and networks with no support and socioeconomic resources are significant risk factors for mental health (e16, e30, e31, e39).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites (e16, e30, e31, e39)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Children can be separated from parents during flight and are especially at risk of violence during and after flight.

    “Children can be separated from their parents during flight (e40) and are particularly at risk of experiencing violence during (e41, e42), as well as after, flight (e43).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites (e40)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites (e41, e42)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites (e43)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductreasoning

    Studies on climate change and mental health cannot be randomized and are only minimally controlled, so their evidence level is usually low to moderate.

    “It should be added by way of caveat that studies looking at the mental health effects of climate change cannot be randomized and only minimally controlled.As a result, their level of evidence is usually low to moderate.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The review does not claim to be a full systematic review.

    “It is not, however, claimed to be a full systematic review.”
    Quote in the paperSubstantial claim

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

    Study design and conductown data

    A selection of studies was assessed using the four-level GRADE evaluation system.

    “A selection is presented in more detail in the eTables 1-3 and assessed using the four-level GRADE evaluation system.”
    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 conductreasoning

    Climate injustice and increased air pollution could not be included in the narrative synthesis because of the large amount of evidence and space limits.

    “It should also be noted that the topics of climate injustice and increase in air pollution, which are less a consequence than a corollary of climate change and were initially intended to be addressed as a separate supplement in this review, could not be included in the narrative synthesis due to the large amount of evidence and for reasons of space.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Germany is experiencing more natural disasters and weather extremes, and a growing mental health disease burden is expected from climate change.

    “Germany too is affected by an increasing number of natural disasters and weather extremes; a progressive disease burden of mental health is to be expected as a result of climate change (e53, e54).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e53, e54)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationcitation

    Climate-related disasters can destroy health care infrastructure while increasing demands on health care.

    “Climate change-related disasters can destroy infrastructures of the health care system and, at the same time, raise demands on health care (e55).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e55)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    A full systematic report was difficult because of the large number of very diverse operationalized surveys.

    “A full systematic report of the results was made difficult by the large number of very diverse operationalized surveys.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    As global warming continues, the general population will likely face a greater mental health burden and more need for mental disorder care.

    “These results indicate that, with progressive global warming, a greater mental health burden on the general population and an increased need for care for mental disorders are to be expected.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Mentally ill people, children, and adolescents are particularly vulnerable to climate change effects.

    “Mentally ill people as well as children and adolescents belong to those groups of people who are particularly vulnerable to the effects of climate change (e50).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e50)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationcitation

    Natural disasters increase the prevalence of PTSD, depression, and anxiety disorders among affected people.

    “Natural disasters raise the prevalence of, above all, PTSD, depression and anxiety disorders of those affected.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Heat worsens many mental disorders, leading to higher morbidity and mortality.

    “Heat makes many mental disorders worse, with subsequent increases in morbidity and mortality.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Environmental migration often moves people from rural to urban areas, removing protective green spaces and adding city-specific mental health risks such as air pollution and noise.

    “Environmental migration often involves moving from rural to urban areas, thus often depriving those affected of an environment with green spaces as a protective factor and putting a strain on mental health with additional city-specific risk factors, such as air pollution and noise (e31, e47).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites (e31, e47)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductnone given

    The systematic literature review was completed on 16 November 2021.

    “The systematic literature review was completed on 16 November 2021.”
    Quote in the paperNot a substantial claim
44 of 44

  • The paper relies on this without support.

    Human activity is the cause of climate change.

    “Climate change is man-made, the consequences of which exceed the capacity of the various ecosystems to adapt.”

  • The paper relies on this without support.

    The effects of climate change go beyond what ecosystems can adapt to.

    “Climate change is man-made, the consequences of which exceed the capacity of the various ecosystems to adapt.”

  • The paper relies on this without support.

    Climate change has caused more flood events.

    “Floods Climate change has led to an increase in flood events, which in turn are particularly associated with an increased prevalence of anxiety disorders, post-traumatic stress disorders (PTSD) as well as symptoms of depression (5)(6)(7)(8)(9).”

  • The authors state this as an assumption.

    Children and adolescents have fewer coping strategies and less self-efficacy after traumatic flood disasters.

    “It is assumed that they have at their disposal fewer coping”

  • The paper relies on this without support.

    Climate change can produce economic and institutional crises.

    “Economic and institutional crises can also arise from climate change.”
5 of 5

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?

  • Recent systematic and scoping reviews have explored diverse concepts such as climate change perceptions or emotions, reported only on direct impacts, or focused on adolescents.

    “Recent systematic and scoping reviews have explored diverse concepts such as climate change perceptions or emotions [22, 23], reported only on the direct impacts of climate change [24–28], or have focused on adolescents [29].”

    From The relationship between climate change and mental health: a systematic review of the association between eco-anxiety, psychological distress, and symptoms of major affective disorders (2024) · cites this paper as [28]

    The cited paper does not report only on direct impacts. Its Methods section says it searched for both direct and indirect effects, including climate-related migration and food insecurity; its Abstract likewise says the review summarizes both. The Narrative synthesis and evaluation section also says it does not claim to be a full systematic review. (LLM, conf=0.91)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(329) = 1.55reported p > .05 · recomputed p = .122

    “t(329) = 1.55, p > .05”

  • Consistentt(328) = 0.43reported p > .05 · recomputed p = .667

    “t(328) = 0.43, p > .05”

2 of 2

Self-check

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

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Baggerly J: International interventions and challenges following the crisis of natural disasters. In: Webb NB (eds.): Play therapy with children in crisis: individual, group, and family treatment, 3rd ed New York, NY: The Guilford Press 2007; 345&#8211;67.
  2. Albrecht G: &#8222;Solastalgia&#8220;: a new concept in health and identity. PAN Philos Act Nat 2005; 3: 41&#8211;55.

Cited by

Sorted by citations

Related

Authors
Walinski, A., Sander, J., Gerlinger, G., Clemens, V., Meyer-Lindenberg, A., & Heinz, A.
Affiliations
Central Institute of Mental Health (DE)
ORCID
Venue
Deutsches Ärzteblatt international
Publisher
Deutscher Arzte-Verlag GmbH
Published
2023-02-24
Volume
120
Issue
8
Pages
117-124
ISSN
1866-0452 (ISSN-L)
DOI
10.3238/arztebl.m2022.0403
PMC
PMC10154789
OpenAlex
W4316928440
Cited by
154
References
92
Citations by year
2026: 34 · 2025: 64 · 2024: 47 · 2023: 9
FWCI
4.10
Type
journal article
Language
de
Open access
Locations
  • Deutsches Ärzteblatt international (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Sociology and Political Science › Climate Change Communication and Perception
Keywords
climate change, mental health, extreme weather events, post-traumatic stress disorder, heat stress, drought, food insecurity, climate-induced migration, psychological distress, psychiatric emergency admission, anxiety disorders, mood disorders, vulnerable populations
MeSH terms
Adolescent, Mental Disorders, Child, Humans, Mental Health, 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 under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

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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