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Association between climate change awareness-related psychological distress and mental health in people with psychiatric diagnoses or subclinical symptoms: a scoping review

Part of: Environment and Mental Health Understanding and Treating Mood and Anxiety Disorders

Published online by Cambridge University Press:  18 February 2026

Hendrik Peuskens ,
Johan Detraux Open the ORCID record for Johan Detraux [Opens in a new window] ,
Kirsten Catthoor Open the ORCID record for Kirsten Catthoor [Opens in a new window] ,
Kris Van den Broeck Open the ORCID record for Kris Van den Broeck [Opens in a new window] ,
Victor-Emiel Bellens Open the ORCID record for Victor-Emiel Bellens [Opens in a new window] ,
Thomas Vandendriessche ,
Chayenne Van Meel Open the ORCID record for Chayenne Van Meel [Opens in a new window] ,
Marc De Hert ,
Jurjen J. Luykx  and
Maarten Van Den Bossche Open the ORCID record for Maarten Van Den Bossche [Opens in a new window]
...Show all authors
Hendrik Peuskens
Affiliation:
Alexianen Zorggroep Tienen, Psychiatric Clinic, Tienen, Belgium. University Psychiatric Center KU Leuven, Kortenberg, Belgium.
Johan Detraux
Affiliation:
University Psychiatric Center KU Leuven, Kortenberg, Belgium. Research Group Psychiatry, KU Leuven, Leuven, Belgium.
Kirsten Catthoor*
Affiliation:
Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium. Flemish Psychiatric Association, Kortenberg, Belgium. Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.
Kris Van den Broeck
Affiliation:
Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Victor-Emiel Bellens
Affiliation:
Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Thomas Vandendriessche
Affiliation:
KU Leuven Libraries - 2Bergen – Learning Centre Désiré Collen, 3000 Leuven, Belgium.
Chayenne Van Meel
Affiliation:
KU Leuven Libraries - 2Bergen – Learning Centre Désiré Collen, 3000 Leuven, Belgium.
Marc De Hert
Affiliation:
University Psychiatric Center KU Leuven, Kortenberg, Belgium. Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium. Antwerp Health Law and Ethics Chair, AHLEC University Antwerpen, Antwerp, Belgium.
Jurjen J. Luykx
Affiliation:
Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands. GGZ inGeest Mental Health Care, Amsterdam, The Netherlands. Neuroscience Mood, Anxiety, Psychosis, Stress & Sleep Research Program, Amsterdam University Medical Center, Amsterdam, The Netherlands. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. Public Health Mental Health Research Program, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Maarten Van Den Bossche
Affiliation:
Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium. Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium.
Manuel Morrens
Affiliation:
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium. Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium.
*
Corresponding author: Kirsten Catthoor; Email: kirstencatthoor@yahoo.com

Abstract

Background

The awareness of climate change as a global environmental threat through media consumption and/or social interaction can have a psychological impact on people’s mental health. However, little is known about the association between climate change awareness-related psychological distress (CCARPD) and mental health in people with psychiatric diagnoses or subclinical symptoms.

Methods

A comprehensive and systematic literature search of the PubMed, Embase, Web of Science Core Collection, Scopus, and CENTRAL electronic databases (from inception to February 2025) was conducted, without language restriction, for articles assessing the association between CCARPD and the mental well-being of people in the general and psychiatric populations.

Results

Twenty-eight thousand forty-seven reports were retrieved. Of these, 67 met the inclusion criteria (64 general and 3 psychiatric population studies). The overall correlation between CCARPD and mental health measurements (ranging from subclinical symptoms to clinical diagnoses of depression, anxiety, or stress) was positive and of weak-to-moderate strength. Nevertheless, higher psychological distress due to the awareness of climate change was found in those having more severe mental health problems.

Conclusions

Although most studies have found small-to-moderate correlations between CCARPD and mental health measurements, it can be distressing and damaging for those with more severe mental health problems. As CCARPD will increase globally as the climate crisis unfolds in the coming decades while the understanding of the connections between CCARPD and mental well-being is still at an early stage of development, more research will be of utmost relevance, particularly in psychiatric populations.

Keywords

climate awarenessclimate anxietymental healthpsychological distressmental disorder

Information

Type
Review/Meta-analysis
Information
European Psychiatry , Volume 69 , Issue 1 , 2026 , e35
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of European Psychiatric Association

Introduction

Anthropogenic climate changes have been identified by the United Nations and the World Health Organization as “the defining issue of our time” and “the greatest threat to global health in the 21st century” [1–5]. Although most of the attention has been placed on physical health impacts of climate changes, mental health challenges are also expected to increase [Reference Türkarslan, Kozak and Yıldırım6–Reference Parker, Wellbery and Mueller10].

Climate change can affect mental health directly due to acute events (e.g., the development of a post-traumatic stress disorder [PTSD] after climate-related disaster exposure), or indirectly through slow-moving consequences of climate change on landscape or agriculture (e.g., the development of psychological distress among indigenous people due to drought, the rising of sea levels, or the loss of biodiversity). However, even without experiencing the direct or indirect effects of climate change, simply the awareness or perception of climate change as a global environmental threat through media consumption (including newspapers, scientific articles, social media, radio, television, and the internet) and/or social interactions also can have a psychological impact on people’s mental health [Reference Léger-Goodes, Malboeuf-Hurtubise, Mastine, Généreux, Paradis and Camden8, Reference Martin, Reilly, Everitt and Gilliland9, Reference Gianfredi, Mazziotta, Clerici, Astorri, Oliani and Cappellina11–Reference Berry, Bowen and Kjellstrom28].

Public awareness of the effects of climate change is rising due to growing media coverage of climate change-related consequences [Reference Léger-Goodes, Malboeuf-Hurtubise, Mastine, Généreux, Paradis and Camden8, Reference Baudon and Jachens29]. Since 2007, media reports on climate change have increased by almost 80% [Reference Hayes, Blashki, Wiseman, Burke and Reifels30]. Moreover, media dissemination of information about climate change frequently contains items highlighting the likely negative, even catastrophic consequences of these changes [Reference Jones, Wootton, Vaccaro and Menzies27]. This explains why large-scale survey studies have shown that the majority of people believe that climate change is a global emergency [Reference Lewandowski, Clayton, Olbrich, Sakshaug, Wray and Schwartz31, Reference Tam, Chan and Clayton32].

Although people with preexisting (severe) mental illness are particularly vulnerable to the direct and indirect impacts of climate change [Reference Betro’13, Reference Braithwaite16, Reference Georgiou, Xekalakis and Parlalis33–Reference Woodland, Ratwatte, Phalkey and Gillingham35], they may also be more vulnerable to increased psychological distress as a consequence of thinking about the future threat that climate change poses [Reference Jones, Wootton, Vaccaro and Menzies27, Reference Aktaş, Ayhan and Karan36–Reference Taylor41]. Constant media exposure to these sources of information and images may engender anxiety, depressive, or stressful symptoms [Reference Stokols, Misra, Runnerstrom and Hipp42], possibly leading to an exacerbation of their disease [Reference Croasdale, Grailey, Jennings, Mole and Lawrance17, Reference Cianconi, Betrò and Janiri23, Reference Lawrance, Jennings, Kioupi, Thompson, Diffey and Vercammen43, Reference Every-Palmer, McBride, Berry and Menkes44]. However, little is known about the relationship between climate change awareness-related psychological distress (CCARPD) and the mental health of people with preexisting mental illness. Therefore, the objective of this study was to conduct a scoping review to systematically map the research done on the association between CCARPD and the mental health of people with preexisting lifetime or current mental illness, as well as to identify the existing gaps in this research. Due to the expected small number of studies available in this research field, we decided to include also studies using samples of people with mental health vulnerabilities from the general population (i.e., people with subclinical symptoms or people having previously received treatment or support for mental health problems/diagnoses undermining daily functioning).

Methods

This scoping review was conducted according to the 2018 Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines [Reference Tricco, Lillie, Zarin, O’Brien, Colquhoun and Levac45], and the 2020 scoping reviews chapter in the JBI Manual for Evidence Synthesis [Reference Peters, Godfrey, McInerney, Munn, Tricco, Khalil, Aromataris and Munn46], which is congruent with the PRISMA-ScR checklist. The protocol was registered with the Open Science Framework initiative (https://osf.io/t59mg/) on May 5, 2023.

Search strategy

A comprehensive and systematic literature search in PubMed (via NCBI, including MEDLINE), Embase (Embase.com), Web of Science Core Collection (SCI-EXPANDED, SSCI, AHCI, CPCI-S, CPCI-SSH, ESCI), Scopus (Scopus.com), and CENTRAL (via Cochrane Library) electronic databases (from inception to February 2025) was conducted on April 13, 2023 (with updates on July 1, 2024 and February 27, 2025). The search was performed without language restriction to identify records assessing the association between CCARPD and the mental well-being of people with psychiatric diagnoses or subclinical symptoms in psychiatric and general populations. Four of the authors, of whom two are experienced biomedical information specialists, closely worked together to construct search strings for the different databases. Full search strings are available in the Supplementary Material. Duplicates of the original search were removed, using EndNote 20 (based on the instructions provided by Leeds University Library).Footnote 1 After removing duplicates, titles and abstracts were screened, using Rayyan QCRI. Articles that were deemed potentially relevant according to the selection criteria were included. Any doubts were solved by consensus or by decision of a second and/or third reviewer. We also attempted to identify additional studies through a process of backward citation searching, using the references of identified relevant reports on CCARPD and mental health [Reference Hirt, Nordhausen, Fuerst, Ewald and Appenzeller-Herzog47].

Selection criteria

All inclusion and exclusion criteria are presented in Table 1. We included studies exploring the relationship between CCARPD (anxiety, depression, and/or stress) and the mental health of people with preexisting or probable mental illness. CCARPD operates along a single continuum from mild concern to severe psychological distress [Reference Hannachi, Yakimova and Somat49]. As clinicians, we decided to focus on the more severe forms of CCARPD, as these are especially relevant as indicators of poor mental health [Reference Chan, Lin, Tam and Hong50–Reference Whitmarsh, Player, Jiongco, James, Williams and Marks54]. Environmental worry or concern, a cognitive phenomenon with affective repercussions but without interfering with one’s daily functioning [Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Gago and Sá56], for example, is often considered to be a less severe form of CCARPD [Reference Chan, Lin, Tam and Hong50, Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Stewart, Chapman and Davis57]. Therefore, we only included studies using at least some functional impairment measure [Reference Owczarek, Redican, Shevlin and Nolan48], meaning that the CCARPD had to interfere with a person’s ability to work, study or socialize, leading to a reduction in quality of life.

Table 1.

Inclusion and exclusion criteria of studies

Abbreviations: CCARPD, Climate Change Awareness-Related Psychological Distress; MDD, Major Depressive Disorder; N/A, Not Applicable.

Data extraction

Data were extracted and mapped descriptively by JD, using a data extraction form, one for studies done within the general population, and one for studies within the clinical population. This extraction form included the following information:

  • - author(s);

  • - country (where the study was conducted);

  • - study design;

  • - patient characteristics (sample size, female gender, mean age, specific information on clinical symptoms, or previous psychological support);

  • - information on screening tools and on outcomes collected as an exposure or mental health outcome;

  • - outcomes/key findings that relate to the scoping review questions.

As a meta-analysis was not feasible, due to the expected high methodological heterogeneity between studies, descriptive statistics were used to summarize study and patient characteristics.

Results

Search strategy

The search in PubMed (n = 3,156), Embase (n = 3,990), Web of Science Core Collection (n = 10,239), Scopus (n = 10,461), and Cochrane (n = 201) databases yielded a total of 28,047 reports. From these, 12,869 duplicates were removed. Overall, 795 references of published records were selected as potentially eligible, of which 67 records [Reference Türkarslan, Kozak and Yıldırım6, Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Jones, Wootton, Vaccaro and Menzies27, Reference Lawrance, Jennings, Kioupi, Thompson, Diffey and Vercammen43, Reference Chan, Lin, Tam and Hong50–Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Lau, Appiah, Ho, Cheng and Yang58–Reference Gebhardt, Schwaab, Friederich and Nikendei114] met the inclusion criteria. One record [Reference Cameron and Kagee61] was identified through backward citation searching. The results of the study selection are shown in the PRISMA flowchart (see Figure 1).

Figure 1.

PRISMA flowchart.

Study and patient characteristics

Sixty-seven records were included in this scoping review (see Tables 2–4). Sixty-four studies were conducted in the general population; three concerned psychiatric population studies. Most general population studies had a cross-sectional design (n = 61) (of which one [Reference Carlson, Foley and Fang77] also included MRI data, two [Reference Hajek and König104, Reference Hajek and König105] were based on the same patient population, and three [Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Vercammen, Oswald and Lawrance96, Reference Hogg, Stanley, O’Brien, Wilson and Watsford110] had a mixed methods design (presenting quantitative and qualitative data). Veijonaho et al. [Reference Veijonaho, Ojala, Hietajärvi and Salmela-Aro81], Whitmarsh et al. [Reference Whitmarsh, Player, Jiongco, James, Williams and Marks54], and Chan et al. [Reference Chan, Lin, Tam and Hong50] were longitudinal studies. Two of the psychiatric population records were cross-sectional studies [Reference Lerolle, Micoulaud-Franchi, Fourneret, Heeren and Gauld113, Reference Gebhardt, Schwaab, Friederich and Nikendei114], one [Reference Jones, Wootton, Vaccaro and Menzies27] a naturalistic study. Mean age of the participants for the general and psychiatric population studies (N = 47,687) was 32 years (range: 14–55 years). Sample sizes ranged from 42 to 3,091 participants. All studies, except the Yesildere Saglam and Sahin [Reference Yesildere Saglam and Mizrak Sahin62], Chan et al. [Reference Chan, Tam and Clayton67], Weiß et al. [Reference Weiß, Gutzeit and Hein70], Hogg et al. [Reference Hogg, Stanley and O’Brien75], Veijonaho et al. [Reference Veijonaho, Ojala, Hietajärvi and Salmela-Aro81], Lukacs et al. [Reference Lukacs, Bratu, Adams, Logie, Tok and McCunn98], Feather and Williams [Reference Feather and Williams103], Hajek and König [Reference Hajek and König104, Reference Hajek and König105], Clayton and Karazsia [Reference Clayton and Karazsia112], and Jones et al. [Reference Jones, Wootton, Vaccaro and Menzies27] studies, included more female participants (mean: 63,8%). Forty percent of the studies were conducted in Europe (Germany, n = 12; France, n = 6; Italy, n = 3; Poland, n = 4; Slovenia, n = 1; Finland, n = 1). The other studies were done in Australia/New Zealand (n = 9), the United States (n = 5), Turkey (n = 6), Canada (n = 4), the United Kingdom (n = 3), China (n = 2), Lebanon (n = 2), Libya (n = 1), South Africa (n = 1), or multiple countries (n = 7). Most studies used specifically designed scales to measure climate change anxiety, which were in most cases the Climate Change Anxiety Scale (CCAS) (n = 44) and the Hogg Eco-Anxiety Scale (n = 15). Three studies used the Climate Distress Scale, two the Eco-Anxiety Questionnaire and one the Climate Change Distress and Impairment Scale. Nearly three-fourth of the non-clinical population studies (n = 33) measured two or more categories of symptoms (i.e., depression, anxiety, and/or stress), using one or more of the above-mentioned scales.

Table 2.

Study and patient characteristics of studies in general population individuals with subclinical symptoms or mental diagnoses [Reference Türkarslan, Kozak and Yıldırım6, Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Lawrance, Jennings, Kioupi, Thompson, Diffey and Vercammen43, Reference Chan, Lin, Tam and Hong50–Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Lau, Appiah, Ho, Cheng and Yang58–Reference Clayton and Karazsia112]

Abbreviations: BDI-II, Beck Depression Inventory-II; BFI-10, Short 10-item Big Five Inventory; BFI-15, Short 15-item Big Five Inventory; BHS, Beck Hopelessness Scale; BSI, Brief Symptom Inventory; CCA, Climate Change Anxiety; CCARS, Climate Change Awareness-Related Distress; CCAS, Climate Change Anxiety Scale; CCAS-S, Climate Change Anxiety Scale Short-Form (abbreviated 4-item version of the CCAS); CCDIS, Climate Change Distress and Impairment Scale; CDS, Climate Distress Scale; CES-D-10, Center for Epidemiologic Studies Depression Scale, 10-item version; CES-D-8, Center for Epidemiologic Studies Depression Scale, 8-item version; CSD, Cross-Sectional Design; DASS-8, Depression Anxiety Stress Scale, 8-item version; DASS-21, Depression Anxiety Stress Scale, 21-item version; DASS-42, Depression Anxiety Stress Scale, 42-item version; DEPS-10, The Depression Scale, 10-item version; DERS-SF, Difficulties in Emotion Regulation Scale – Short Form; DT, Distress Thermometer; EAQ-22, Eco-Anxiety Questionnaire; EID, Environmental Identity Scale; EMEA, Eco-Anxiety Measurement Scale; EPDS, Edinburgh Postnatal Depression Scale; GAD, General Anxiety Disorder; GAD-9, General Anxiety Disorder scale, 9-item version; GAD-7, General Anxiety Disorder scale, 7-item version; GAD-7-C, The climate change specific General Anxiety Disorder scale, 7-item version; GAD-2, General Anxiety Disorder scale, 2-item version; GAD-4, General Anxiety Disorder scale, 4-item version; HAD, Hospital Anxiety and Depression Scale; HEAS, Hogg Eco-Anxiety Scale; K-10, Kessler Psychological Distress Scale, 10-item version; K-6, Kessler Psychological Distress Scale, 6-item version; MDD, Major Depressive Disorder; MHC-SF, Mental Health Continuum-Short Form; MHW-12, Modern Health Worries scale (12 questions); MRI, Magnetic Resonance Imaging; MMS, Mixed-Methods Study; NEO-FFI, NEO Five-Factor Inventory; NR, Not Reported; PANAS-X, Positive and Negative Affect Schedule- expanded form; PHQ-4, Patient Health Questionnaire for depression and anxiety, 4-item version; PHQ-8, Patient Health Questionnaire for depression, 8-item version; PHQ-9, Patient Health Questionnaire for depression, 9-item version; PHQ-9-C, The climate change specific Patient Health Questionnaire for depression, 9-item version; PMS, Premenstrual Syndrome; PMSS, Premenstrual Syndrome Scale; PQ-B, Prodromal Questionnaire-Brief; PSIS, Perceived Social Isolation Scale; PSS-4, Perceived Stress Scale, 4-item version; PSWQ, Penn State Worry Questionnaire; PSQ-20, Perceived Stress Questionnaire, 20-item version; PSQ-20-C, the climate change specific Perceived Stress Questionnaire, 20-item version; PTSD-8, Post-Traumatic Stress Disorder, 8-item questionnaire; PTSS-10, Posttraumatic Stress Scale, 10-item version; PTSS-10-C, The climate change specific Posttraumatic Stress Scale, 10-item version; QDIA-SR, Quick Depression Inventory for Adolescents-Self-Report Form; SDA, Scale of Death Anxiety; SDES, Short Defeat and Entrapment Scale; SDQ, Strengths and Difficulties Questionnaire; SIBS, Suicide Ideation and Behavior Scale; SPANE, Scale of Positive and Negative Experiences; SSS-8, Somatic Symptoms Scale (8 categories of somatic symptoms); STAIT-5, State-Trait Anxiety Inventory Scale-5 questionnaire; STAI-Y, Spielberger Trait Anxiety Scale-Form Y; UK, United Kingdom; US, United States; WHO-5, World Health Organization-Five Well-Being Index.

a Since the initial data were collected during the COVID-19 pandemic, potentially affecting climate anxiety levels, the sample was recontacted in late May 2022 to complete the climate anxiety measure a second time; 891 respondents completed the measure. Three percent of the sample had experienced flood damage to their home or garden in the last 5 years.

Table 3.

Results of studies in general population individuals with subclinical symptoms or mental diagnoses [Reference Türkarslan, Kozak and Yıldırım6, Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Lawrance, Jennings, Kioupi, Thompson, Diffey and Vercammen43, Reference Chan, Lin, Tam and Hong50–Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Lau, Appiah, Ho, Cheng and Yang58–Reference Clayton and Karazsia112]

Abbreviations: BDI-II, Beck Depression Inventory-II; BFI-10, Short 10-item Big Five Inventory; BFI-15, Short 15-item Big Five Inventory; BHS, Beck Hopelessness Scale; BSI, Brief Symptom Inventory; CCA, Climate Change Anxiety; CCARS, Climate Change Awareness-Related Distress; CCAS, Climate Change Anxiety Scale; CCAS-S, Climate Change Anxiety Scale Short-Form (abbreviated 4-item version of the CCAS); CCDIS, Climate Change Distress and Impairment Scale; CDS, Climate Distress Scale; CES-D-10, Center for Epidemiologic Studies Depression Scale, 10-item version; CES-D-8, Center for Epidemiologic Studies Depression Scale, 8-item version; CSD, Cross-Sectional Design; DASS-8, Depression Anxiety Stress Scale, 8-item version; DASS-21, Depression Anxiety Stress Scale, 21-item version; DASS-42, Depression Anxiety Stress Scale, 42-item version; DCE, Discrete Choice Experiment; DEPS-10, The Depression Scale, 10-item version; DERS-SF, Difficulties in Emotion Regulation Scale – Short Form; DT, Distress Thermometer; EAQ-22, Eco-Anxiety Questionnaire; EID, Environmental Identity Scale; EMEA, Eco-Anxiety Measurement Scale; EPDS, Edinburgh Postnatal Depression Scale; GAD, General Anxiety Disorder; GAD-2: General Anxiety Disorder scale, 2-item version; GAD-4: General Anxiety Disorder scale, 4-item version; GAD-7, General Anxiety Disorder scale, 7-item version; GAD-7-C, The climate change specific General Anxiety Disorder scale, 7-item version; GAD-9, General Anxiety Disorder scale, 9-item version; HAD, Hospital Anxiety and Depression Scale; HEAS, Hogg Eco-Anxiety Scale; K-6, Kessler Psychological Distress Scale, 6-item version; K-10, Kessler Psychological Distress Scale, 10-item version; MDD, Major Depressive Disorder; MHC-SF, Mental Health Continuum-Short Form; MHW-12, Modern Health Worries scale (12 questions); MMS, Mixed-Methods Study; MRI, Magnetic Resonance Imaging; NEO-FFI, NEO Five-Factor Inventory; NR, Not Reported; PANAS-X, Positive and Negative Affect Schedule- expanded form; PHQ-4, Patient Health Questionnaire for depression and anxiety, 4-item version; PHQ-8, Patient Health Questionnaire for depression, 8-item version; PHQ-9, Patient Health Questionnaire for depression, 9-item version; PHQ-9-C, The climate change specific Patient Health Questionnaire for depression, 9-item version; PMS, Premenstrual Syndrome; PQ-B, Prodromal Questionnaire-Brief; PSIS, Perceived Social Isolation Scale; PSS-4, Perceived Stress Scale, 4-item version; PSWQ, Penn State Worry Questionnaire; PSQ-20, Perceived Stress Questionnaire, 20-item version; PSQ-20-C, the climate change specific Perceived Stress Questionnaire, 20-item version; PTSD-8, Post-Traumatic Stress Disorder, 8-item questionnaire; PTSS-10, Posttraumatic Stress Scale, 10-item version; PTSS-10-C, The climate change specific Posttraumatic Stress Scale, 10-item version; QDIA-SR, Quick Depression Inventory for Adolescents-Self-Report Form; SDA, Scale of Death Anxiety; SDES, Short Defeat and Entrapment Scale; SDQ, Strengths and Difficulties Questionnaire; SIBS, Suicide Ideation and Behavior Scale; SPANE, Scale of Positive and Negative Experiences; SSS-8, Somatic Symptoms Scale (8 categories of somatic symptoms); STAIT-5, State-Trait Anxiety Inventory Scale-5 questionnaire; STAI-Y, Spielberger Trait Anxiety Scale-Form Y; UK, United Kingdom; US, United States; WHO-5, World Health Organization-Five Well-Being Index.

Table 4.

Results of studies in the clinical population [Reference Jones, Wootton, Vaccaro and Menzies27, Reference Lerolle, Micoulaud-Franchi, Fourneret, Heeren and Gauld113, Reference Gebhardt, Schwaab, Friederich and Nikendei114]

Abbreviations: ADHD, Attention Deficit Hyperactivity Disorder; ASD, Autism Spectrum Disorder; BDI, Beck Depression Inventory; CIDI-Auto, The Composite International Diagnostic Interview; C-SSRS, Columbia-Suicide Severity Rating Scale; DASS-21, Depression Anxiety Stress Scale 21; GAD-7, General Anxiety Disorder scale, 7-item version; GAD-7-C, The climate change specific General Anxiety Disorder scale, 7-item version; HAD, Hospital Anxiety and Depression Scale; HEAS, The Hogg Eco-Anxiety Scale; MDD, Major Depressive Disorder; N/A, Not Applicable; OCD, Obsessive Compulsive Disorder; PHQ-9, Patient Health Questionnaire for depression, 9-item version; PHQ-9-C, The climate change specific Patient Health Questionnaire for depression, 9-item version; PTSD, Post-Traumatic Stress Disorder; PTSS-10, Posttraumatic Stress Scale, 10-item version; PTSS-10-C, The climate change specific Posttraumatic Stress Scale, 10-item version; PI-WSUR, Padua Inventory – Washington State University Revision; VOCI, Vancouver Obsessional Compulsive Inventory; Y-BOCS, Yale-Brown Obsessive Compulsive Scale.

Association between CCARPD and mental health in people with psychiatric diagnoses or subclinical symptoms

General population studies

The available evidence shows that in most general population studies [Reference Türkarslan, Kozak and Yıldırım6, Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Lawrance, Jennings, Kioupi, Thompson, Diffey and Vercammen43, Reference Wu, Long, Hafez, Maloney, Lim and Samji51, Reference Hepp, Klein, Horsten, Urbild and Lane52, Reference Whitmarsh, Player, Jiongco, James, Williams and Marks54, Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Lau, Appiah, Ho, Cheng and Yang58–Reference Cameron and Kagee61, Reference Shepherd, Raynal and Guedj64, Reference Wagner and Witthöft65, Reference Chan, Tam and Clayton67–Reference Zeier and Wessa78, Reference Çimşir, Şahin and Akdoğan80, Reference Orrù and Mannarini82, Reference Lykins, Bonich, Sundaraja and Cosh83, Reference Wullenkord, Johansson, Loy, Menzel and Reese85–Reference Micoulaud-Franchi, Coelho, Geoffroy, Vecchierini, Poirot and Royant-Parola88, Reference Nezlek and Cypryańska90, Reference Thomson and Roach93, Reference Mathers-Jones and Todd95, Reference Mathé, Grisetto, Gauvrit and Roger99, Reference Feather and Williams103–Reference Innocenti, Santarelli, Faggi, Castellini, Manelli and Magrini111] significant positive correlations were found between CCARPD and mental health measurements. These correlations, however, were mostly low (r < 0.30) to moderate (r = 0.30–0.49) (see Table 3). Trait anxiety, a personality trait to perceive various events as threatening [Reference Knowles and Olatunji115], also seems to play a minor role as a predictor of climate anxiety-related impairments [Reference Parmentier, Weiss, Aroua, Betry, Rivière and Navarro86].

Studies in general populations have also found that, although individuals at risk for mental illness may experience CCARPD, this distress rarely results in significant functional impairment. Only a minority of these individuals exhibited moderate or severe levels of distress in relation to climate change awareness [Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Wu, Long, Hafez, Maloney, Lim and Samji51, Reference Hepp, Klein, Horsten, Urbild and Lane52, Reference Whitmarsh, Player, Jiongco, James, Williams and Marks54, Reference Schwaab, Gebhardt, Friederich and Nikendei102]. Those who had a clinical history (i.e. previously receiving psychological support or having a mental health disorder) tended to experience higher distress levels due to the awareness of climate change [Reference Ediz and Yanik94, Reference Vercammen, Oswald and Lawrance96]. Vercammen et al. [Reference Vercammen, Oswald and Lawrance96], for example, found in their online survey that the subgroup of those currently diagnosed and/or receiving treatment for a mental health condition were significantly more likely to experience moderate (OR = 1.930) and high levels (OR = 3.116) of CCARPD.

Psychiatric population studies

We found a paucity of literature examining the association between CCARPD and the mental health of people with a preexisting psychiatric diagnosis within clinical populations. Only 3 out of the 67 identified records concerned psychiatric populations (see Table 4).

These studies [Reference Jones, Wootton, Vaccaro and Menzies27, Reference Lerolle, Micoulaud-Franchi, Fourneret, Heeren and Gauld113, Reference Gebhardt, Schwaab, Friederich and Nikendei114] illustrate how CCARPD can have an impact on the content of delusions held by people with a schizophrenia-spectrum disorder or a major depressive disorder with psychotic symptoms, or on the types of obsessions and compulsions experienced by people with obsessive-compulsive disorders. Jones et al. [Reference Jones, Wootton, Vaccaro and Menzies27] found that 28% of their obsessive-compulsive patients had obsessions and compulsions directly related to climate change (such as the obsession that increased air temperatures would result in rapid evaporation of the water in their pet bowls, leading to their pets dying of thirst, followed by checking and rechecking the pet’s water bowl to ensure they held adequate water).

The type of cognitive biases contributing to depressive, anxiety or PTSD symptoms seems to be related to the type of climate change awareness-related symptoms. The study of Gebhardt et al. [Reference Gebhardt, Schwaab, Friederich and Nikendei114], for example, showed patients with depression might focus more on the sadness-related feelings evoked by climate change awareness, whereas those with anxiety disorder or PTSD rather had threat-related feelings evoked by climate change awareness.

Discussion

The positive, but mostly small-to-moderate, correlations between CCARPD and mental health measurements (anxiety, depressive, or stress symptoms) that have been observed across general and psychiatric population studies are in line with those of other recent reviews with distinct research questions and methods [Reference Gago, Sargisson and Milfont116, Reference Cosh, Ryan, Fallander, Robinson, Tognela and Tully117]. The systematic review of Cosh et al. [Reference Cosh, Ryan, Fallander, Robinson, Tognela and Tully117] reported small-to-large positive correlations (r = 0.14 to r = 0.60) between eco-anxiety and depressive, anxiety, or stress symptoms in general population and mental health settings. Eco-anxiety in this review, however, was broadly defined and also included environmental worry, probably explaining why associations with mental health outcomes were more variable than in our review. Moreover, probably partly due to a less extensive and updated search strategy, only 35 studies were included in their review. Gago et al. [Reference Gago, Sargisson and Milfont116], finding a moderate negative correlation (r = −0.30) between eco-anxiety and psychological well-being, limited their analyses to eco-anxiety as measured by the CCAS. Despite this, all these results suggest that people with mental health vulnerabilities may be more prone to experience higher levels of CCARPD and functional impairment. However, as these data are cross sectional, they are insufficient to establish a causal relationship between potential or preexisting psychopathology and higher levels of CCARPD. It is plausible that people with mental health vulnerabilities look at climate change-related events with a general negative bias, leading to higher states of anxiety, depression, and/or stress. On the other hand, it is also likely that the awareness of climate-related changes is potentially stressful and detrimental to overall mental health and particularly might be a risk factor for these individuals. The resulting negative thoughts and feelings may as such contribute to the exacerbation or even the development of psychiatric disorders. There might also be a bidirectional association between both variables [Reference Ogunbode, Pallesen, Böhm, Doran, Bhullar and Aquino21, Reference Ogunbode, Doran and Böhm22, Reference Hogg, Stanley and O’Brien75, Reference Zeier and Wessa78, Reference Er, Murat, Ata, Köse and Buzlu89, Reference Hogg, Stanley and O’Brien118–Reference Searle and Gow120].

There is still little consensus on how to conceptualize CCARPD from a mental health standpoint [Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Vukičević and Liu121]. Most authors, mental health professionals, and climate scientists [Reference Türkarslan, Kozak and Yıldırım6–Reference Martin, Reilly, Everitt and Gilliland9, Reference Treble, Cosma and Martin15, Reference Croasdale, Grailey, Jennings, Mole and Lawrance17, Reference Trost, Ertl, König, Rosner and Comtesse37, Reference Lawrance, Jennings, Kioupi, Thompson, Diffey and Vercammen43, Reference Carlson, Foley and Fang77, Reference Veijonaho, Ojala, Hietajärvi and Salmela-Aro81, Reference Hogg, Stanley, O’Brien, Watsford and Walker84, Reference Nezlek and Cypryańska90, Reference Patrick, Snell, Gunasiri, Garad, Meadows and Enticott92, Reference Heinzel, Tschorn, Schulte-Hutner, Schäfer, Reese and Pohle97, Reference Hogg, Stanley, O’Brien, Wilson and Watsford110, Reference Gago, Sargisson and Milfont116, Reference Butler and Rao122–Reference Verplanken and Roy130] agree that emotional reactions to climate change should not be pathologized and can be seen as an adequate, adaptive, functional, justifiable, and rational response to the serious threats facing the planet and its inhabitants. Moreover, some [Reference Dodds131] have even argued that it might be pathological to have too little CCARPD, given the urgency of climate action.

There is no doubt that climate change poses an existential threat to humans and other living organisms [Reference Passmore, Lutz and Howell132, Reference Ramadan and Ataallah133]. The global ecological crisis has indeed been related to many existential concerns and deep feelings of ontological insecurity [Reference Wullenkord, Tröger, Hamann, Loy and Reese109, Reference Panu129, Reference Hajek and König134, Reference Laing135]. This existential threat challenges prevailing values, ethics, and way of thinking and imposes a set of constraints on human behavior (such as [mental] health and forced migration) and basic preconditions (such as food security) [Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Crandon, Scott, Charlson and Thomas125, Reference Ramadan and Ataallah133]. Given its existential nature, it is not surprising and quite plausible that CCARPD is experienced by numerous people who do not suffer from mental health issues.

However, irrespective of whether it represents a rational concern, results highlight that CCARPD may also be overwhelming, “irrationally high,” excessive, and uncontrollable, and may reach levels that interfere with an individual’s ability to function, especially for people with underlying symptoms of anxiety, depression, or stress [Reference Türkarslan, Kozak and Yıldırım6, Reference Ramadan, Randell, Lavoie, Gao, Manrique and Anderson7, Reference Martin, Reilly, Everitt and Gilliland9, Reference Treble, Cosma and Martin15, Reference Croasdale, Grailey, Jennings, Mole and Lawrance17, Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Trost, Ertl, König, Rosner and Comtesse37, Reference Lawrance, Thompson, Newberry Le Vay, Page and Jennings39, Reference Cosh, Williams, Lykins, Bartik and Tully63, Reference Veijonaho, Ojala, Hietajärvi and Salmela-Aro81, Reference Wullenkord, Johansson, Loy, Menzel and Reese85, Reference Patrick, Snell, Gunasiri, Garad, Meadows and Enticott92, Reference Heinzel, Tschorn, Schulte-Hutner, Schäfer, Reese and Pohle97, Reference Clayton and Karazsia112, Reference Gago, Sargisson and Milfont116, Reference Crandon, Scott, Charlson and Thomas125, Reference Cunsolo, Harper, Minor, Hayes, Williams and Howard128, Reference Magruder and Chipman136, Reference Christodoulou, Laaidi and Geoffroy137].

Several studies found a strong association between CCARPD and pro-environmental attitudes or behaviors, even when controlling for several correlates of environmental behavior (e.g., political ideology) [Reference Schwartz, Benoit, Clayton, Parnes, Swenson and Lowe18, Reference Tucholska, Gulla and Ziernicka-Wojtaszek74, Reference Hogg, Stanley, O’Brien, Watsford and Walker84, Reference Wullenkord, Tröger, Hamann, Loy and Reese109, Reference Hogg, Stanley, O’Brien, Wilson and Watsford110, Reference Verplanken and Roy130, Reference Ballew, Uppalapati, Myers, Carman, Campbell and Rosenthal138], suggesting that CCARPD may be a constructive form of distress and stimulate individuals to adopt behaviors that can counteract climate change (identified as the concerned steward effect or a coping mechanism) [Reference Lukacs, Bratu, Adams, Logie, Tok and McCunn98, Reference Innocenti, Perilli, Santarelli, Carluccio, Zjalic and Acquadro Maran100, Reference Wullenkord, Tröger, Hamann, Loy and Reese109]. Thus, it seems that low-to-moderate levels of CCARPD (particularly anxiety symptoms) may be essential and required to take ecological problems seriously and engage in pro-environmental behaviors. High or excessive levels of CCARPD, however, can have a paralyzing effect on pro-environmental behaviors [Reference Innocenti, Perilli, Santarelli, Carluccio, Zjalic and Acquadro Maran100, Reference Heeren, Mouguiama-Daouda and Contreras101, Reference Wullenkord, Tröger, Hamann, Loy and Reese109, Reference Christodoulou, Laaidi and Geoffroy137]. Heeren et al. [Reference Heeren, Mouguiama-Daouda and Contreras101] have shown that the relationship between CCARPD and pro-environmental behavior is weakest in individuals with the highest levels of CCARPD, suggesting that CCARPD in cases of high anxiety levels is not adaptive. Symptoms of CCARPD may also be more pronounced in individuals who lack emotional regulation skills. Emotional regulation is the individual’s ability to identify and regulate the emotions they have. In those with high levels of emotion dysregulation, climate change awareness-related anxiety may reach levels that deteriorate daily functioning, predicting worse mental health outcomes [Reference Orrù and Mannarini82].

An important question here is whether CCARPD also deserves a special status (as a separate disorder) in the existing psychiatric classifications [Reference Gregersen, Doran, Ogunbode and Böhm139]. Some health professionals, for example, see CCARPD as a form of “pre-traumatic stress disorder,” in which traumatic consequences are anticipated and felt (i.e., pre-traumatic stress symptoms, including patterns of avoidance and symptoms of hypervigilance) before the event even takes place [Reference Baudon and Jachens29, Reference Patrick, Snell, Gunasiri, Garad, Meadows and Enticott92, Reference Babbott140]. However, until now, current diagnostic manuals (i.e., the DSM-5-TR and ICD-11) do not include ecological disorders such as eco-anxiety or climate change awareness-related phobia, depression, or obsessions/compulsions [Reference Magruder and Chipman136].

Given that various environmental issues are expected to worsen and humanity does not presently seem able to stop it effectively, CCARPD is likely to become a greater focus for mental health professionals and psychotherapists in the coming years [Reference Croasdale, Grailey, Jennings, Mole and Lawrance17, Reference Baudon and Jachens29, Reference Trost, Ertl, König, Rosner and Comtesse37, Reference Lutz, Passmore, Howell, Zelenski, Yang and Richardson55, Reference Raile141]. Mental health professionals and psychotherapists already are increasingly reporting counseling individuals dealing with CCARPD [Reference Martin, Reilly, Everitt and Gilliland9, Reference Trost, Ertl, König, Rosner and Comtesse37, Reference Lawton142, Reference Budziszewska and Jonsson143]. In a nationwide sample of German psychotherapists (N = 573), for example, about 72% of them indicated having patients with climate change-related concerns [Reference Trost, Ertl, König, Rosner and Comtesse37]. Findings suggest, however, that these issues are not yet adequately addressed in psychotherapy [Reference Bahar, Rego and Sadeh-Sharvit144]. Psychotherapists therefore should be prepared to address them.

The development of psychotherapeutic interventions to address the adverse mental health effects of climate changes have already been indicated by the American Psychiatric Association and the European Psychiatric Association as a legitimate focus of psychiatrists and psychologists [Reference Brandt, Adorjan, Catthoor, Chkonia, Falkai and Fiorillo145–Reference Vidal and Latkin147], hereby emphasizing a salutogenic (i.e., identifying and promoting factors that contribute to well-being), rather than a pathogenic approach [Reference Patrick, Snell, Gunasiri, Garad, Meadows and Enticott92, Reference Pitt, Norris and Pecl123]. Acceptance and commitment therapy, for example, may be appropriate, as it focuses on validating experienced emotions and changing the individual’s relationship to their thoughts and cognitions, rather than questioning their validity. It also encourages patients to be fully engaged and present in the current moment, rather than dwelling on the past (e.g., eco-grief) or worrying about the future (e.g., eco-anxiety), and to take action to address environmental issues [Reference Croasdale, Grailey, Jennings, Mole and Lawrance17, Reference Hogg, Stanley, O’Brien, Watsford and Walker84, Reference Magruder and Chipman136]. According to Hogg et al. [Reference Hogg, Stanley, O’Brien, Watsford and Walker84], components of Dialectical Behavior Therapy that help people develop insight into their CCARPD (e.g., what triggers it, how it manifests, what its function is) may also indirectly benefit well-being. Several other therapies, including environmental identity-based therapies [Reference Doherty and Clayton148], nature-based art therapy [Reference Wardle149], and the CliMACT training [Reference Reininghaus150], are explored to see how they can support people with CCARPD within the context of the ecological crisis. Interventions involving cognitive reappraisal of anxiety-provoking objects as less threatening, on the other hand, may not be appropriate given the genuine threat of climate change [Reference Mathers-Jones and Todd95]. Making individual behavioral changes to cut one’s global footprint may be seen as another way of decreasing climate change anxiety because the person now feels that they are helping to address the problem. However, for people with obsessive compulsive disorder, it is possible that this approach can actually exacerbate the anxiety and contribute to further checking [Reference Jones, Wootton, Vaccaro and Menzies27].

This scoping review identified several research gaps. First, concept and terminology of CCARPD needs to be better defined [Reference Owczarek, Redican, Shevlin and Nolan48, Reference Orrù and Mannarini82, Reference van Dijk, van Schie, Smeets and Mertens151], as it may restrict replicability and comparability of studies [Reference van Dijk, van Schie, Smeets and Mertens151]. There exists still no formal definition of CCARPD [Reference Lawton142]. According to Orrù and Mannarini [Reference Orrù and Mannarini82] more than ten distinct operationalizations of this concept are currently used in the literature. This is reflected in the diverse ranges of measures, complicating efforts to compare findings across studies [Reference Owczarek, Redican, Shevlin and Nolan48, Reference van Dijk, van Schie, Smeets and Mertens151]. Second, more research on the association between CCARPD and mental health in people is necessary, particularly in clinical populations and young people. Moreover, future research should also examine how one can help these people cope with negative emotions about climate change and explore the role of mental practitioners herein. Third, most of the conducted studies have a cross-sectional design. This design cannot be used to infer causality between CCARPD and mental health. It is therefore impossible to understand how CCARPD and mental health affect each other over time [Reference Jarrett, Gauthier, Baden, Ainsworth and Dorey152]. Longitudinal studies to assess the direction(s) of causality between CCARPD and mental disorders therefore are needed, as well as specific studies examining the role of coping strategies (coping strategies people use to reduce their anxiety over time cannot be uncovered in cross-sectional designs) [Reference Wullenkord, Tröger, Hamann, Loy and Reese109]. Fourth, several studies, particularly those in the United States and Australia, may have some bias selection toward direct and/or indirect consequences of climate change. As particularly these areas are affected by climate change such as bushfires, floods, and extreme heat waves, one can wonder whether the included studies only measured climate change awareness or also direct and indirect effects of climate change. A nation-wide Australian study [Reference Patrick, Snell, Gunasiri, Garad, Meadows and Enticott92], approximately representative of adults in Australia, showed that in their large sample the majority of Australians (54.63%) already had a direct experience of a climate change-related event (e.g., directly affected by bushfire, flood, extreme heat wave). Another limitation is the methodological problem of self-report bias in the selected studies. It is important to know that all psychological scales that have been used in non-clinical population studies are self-report measures of anxiety or depressive symptoms and only indicative for clinically confirmed psychiatric diagnoses such as generalized anxiety disorder. Respondents may also underreport symptoms of mental health disorders, potentially weakening study measures [Reference Hunt, Auriemma and Cashaw153]. Future general population studies therefore should try to use other measures, such as structural mental health interviews [Reference Wu, Long, Hafez, Maloney, Lim and Samji51]. Finally, studies examining the association between CCARPD and mental health also fail to explicitly account for differences in the content and valence of climate change information conveyed to audiences by the media. Not only the mere volume of media exposure, but also the content of the information and the amount of attention people pay to it is important. Some studies suggest that media attention may be a better predictor of CCARPD than media exposure alone [Reference Whitmarsh, Player, Jiongco, James, Williams and Marks54, Reference Ogunbode, Doran, Hanss, Ojala, Salmela-Aro and van den Broek154].

A key strength of this review certainly is the extensive search strategies, including several databases (see Supplementary Material) to identify relevant studies on this topic. The search was also performed without language restrictions. Although we included studies with a mixed methods design, a major limitation is that our primary goal was to collect and analyze numerical, quantitative data. The inclusion of more qualitative data probably would have provided more in-depth, rich insights into the complex associations between CCARPD and mental health.

Conclusion

Although CCARPD in most cases represents a reasonable and comprehensible reaction to serious environmental issues, our review shows that it can still be dysfunctional for people with mental health vulnerabilities, sometimes requiring professional support. As CCARPD will increase globally as the climate crisis unfolds in the coming decades while the understanding of the connections between CCARPD and mental well-being is still at an early stage of development, more research will be of utmost relevance. Particularly research in psychiatric populations is urgently needed to investigate how CCARPD may contribute to the exacerbation or reemergence of preexisting psychiatric disorders and how standard psychotherapeutic interventions should be adapted to address CCARPD in these populations successfully. In this regard, the development of clinical cut-off scores for CCARPD (such as these proposed by the systematic review of Cosh et al. [Reference Cosh, Williams, Lykins, Bartik and Tully63], i.e., ≥21 on the CCAS for mild-moderate CCARPD, and ≥23 on the CCAS for severe-extremely severe CCARPD) may be opportune to guide clinical practice.

Supplementary material

The supplementary material for this article can be found at http://doi.org/10.1192/j.eurpsy.2026.10169.

Data availability statement

The search strings are available as supplementary material.

Author contribution

H.P, J.D., K.C., K.V.d.B, M.D.H., and M.M. conceptualized the study. J.D., V-E. B., T.V., and C.V.M. outlined the search strategy. J.D. performed the literature search and wrote the draft of the manuscript. All authors gave their feedback on the drafts of the manuscript. J.D. revised the manuscript. All authors have read and approved the manuscript.

Financial support

This work has been financed by an unrestricted grant from Johnson & Johnson and Lundbeck.

Competing interests

The authors declare that there are no conflicts of interest relevant to this work.

Financial disclosures for the previous 12 months

All authors declare that there are no additional disclosures to report.

References

United Nations. Climate change. 2024. https://www.un.org/en/global-issues/climate-change#:~:text=Climate%20Change%20is%20the%20defining,scope%20and%20unprecedented%20in%20scale. Last Access: June 3, 2025.Google Scholar
Parums, DV. A review of the increasing global impact of climate change on human health and approaches to medical preparedness. Med Sci Monit. 2024;30:e945763. doi:10.12659/MSM.945763.Google Scholar
Intergovernmental Panel on Climate Change (IPCC). Climate change 2023: synthesis report. Contribution of working groups I, II and III to the sixth assessment report of the intergovernmental panel on climate change [Core Writing Team, Lee, H. and Romero, J. (eds.)]. Geneva, Switzerland: IPCC; 2023, 184 pp, doi:10.59327/IPCC/AR6-9789291691647.Google Scholar
Usher, K, Durkin, J, Bhullar, N. Eco-anxiety: how thinking about climate change-related environmental decline is affecting our mental health. Int J Ment Health Nurs. 2019;28(6):1233–4. doi:10.1111/inm.12673.Google Scholar
World Health Organization. WHO calls for urgent action to protect health from climate change – sign the call. 2015. https://www.who.int/news/item/06-10-2015-who-calls-for-urgent-action-to-protect-health-from-climate-change-sign-the-call#:~:text=Sign%20the%20call-,WHO%20calls%20for%20urgent%20action%20to%20protect,climate%20change%20%E2%80%93%20Sign%20the%20call&text=The%20evidence%20is%20overwhelming%3A%20climate,decisively%20to%20change%20this%20trajectory.&text=Climate%20change%20is%20the%20greatest,health%20in%20the%2021st%20century. Last Access: June 3, 2025.Google Scholar
Türkarslan, KK, Kozak, ED, Yıldırım, JC. Psychometric properties of the Hogg Eco-Anxiety Scale (HEAS-13) and the prediction of pro-environmental behavior. J Environ Psychol. 2023;92:102147. doi:10.1016/j.jenvp.2023.102147.Google Scholar
Ramadan, R, Randell, A, Lavoie, S, Gao, CX, Manrique, PC, Anderson, R, et al. Empirical evidence for climate concerns, negative emotions and climate-related mental ill-health in young people: a scoping review. Early Interv Psychiatry. 2023;17(6):537–63. doi:10.1111/eip.13374.Google Scholar
Léger-Goodes, T, Malboeuf-Hurtubise, C, Mastine, T, Généreux, M, Paradis, PO, Camden, C. Eco-anxiety in children: a scoping review of the mental health impacts of the awareness of climate change. Front Psychol. 2022;13:872544. doi:10.3389/fpsyg.2022.872544.Google Scholar
Martin, G, Reilly, K, Everitt, H, Gilliland, JA. Review: the impact of climate change awareness on children’s mental well-being and negative emotions – a scoping review. Child Adolesc Ment Health. 2022;27(1):59–72. doi:10.1111/camh.12525.Google Scholar
Parker, CL, Wellbery, CE, Mueller, M. The changing climate: managing health impacts. Am Fam Physician. 2019;100(10):618–26.Google Scholar
Gianfredi, V, Mazziotta, F, Clerici, G, Astorri, E, Oliani, F, Cappellina, M, et al. Climate change perception and mental health. Results from a systematic review of the literature. Eur J Investig Health Psychol Educ. 2024;14(1):215–29. doi:10.3390/ejihpe14010014.Google Scholar
Parnes, MF, Amort, B, Calderon-Smith, C, Chambers, EC, Musicaro, R. Child and adolescent engagement with climate change on social media and impacts on mental health: a narrative review. Curr Pediatr Rep. 2024;12:158–67. doi:10.1007/s40124-024-00331-9.Google Scholar
Betro’, S. From eco-anxiety to eco-hope: surviving the climate change threat. Front Psych. 2024;15:1429571. doi:10.3389/fpsyt.2024.1429571.Google Scholar
Proulx, K, Daelmans, B, Baltag, V, Banati, P. Climate change impacts on child and adolescent health and well-being: a narrative review. J Glob Health. 2024;14:04061. doi:10.7189/jogh.14.04061.Google Scholar
Treble, M, Cosma, A, Martin, G. Child and adolescent psychological reactions to climate change: a narrative review through an existential lens. Curr Psychiatry Rep. 2023;25(8):357–63. doi:10.1007/s11920-023-01430-y.Google Scholar
Braithwaite, V. Climate change and mental illness: what psychiatrists can do. Curr Psychiatr Ther 2023;22(9):32–9. https://cdn.mdedge.com/files/s3fs-public/CP02209032.pdfFGoogle Scholar
Croasdale, K, Grailey, K, Jennings, N, Mole, J, Lawrance, EL. Planning for the perfect storm: perceptions of UK mental health professionals on the increasing impacts of climate change on their service users. J Clim Change Health. 2023;13:100253. doi:10.1016/j.joclim.2023.100253.Google Scholar
Schwartz, SEO, Benoit, L, Clayton, S, Parnes, MF, Swenson, L, Lowe, SR. Climate change anxiety and mental health: environmental activism as buffer. Curr Psychol. 2023;42:16708–21.Google Scholar
Boluda-Verdú, I, Senent-Valero, M, Casas-Escolano, M, Matijasevich, A, Pastor-Valero, M. Fear for the future: eco-anxiety and health implications, a systematic review. J Environ Psychol. 2022;84:101904. doi:10.1016/j.jenvp.2022.101904.Google Scholar
Clemens, V, von Hirschhausen, E, Fegert, JM. Report of the intergovernmental panel on climate change: implications for the mental health policy of children and adolescents in Europe-a scoping review. Eur Child Adolesc Psychiatry. 2022;31(5):701–13. doi:10.1007/s00787-020-01615-3.Google Scholar
Ogunbode, CA, Pallesen, S, Böhm, G, Doran, R, Bhullar, N, Aquino, S, et al. Negative emotions about climate change are related to insomnia symptoms and mental health: cross-sectional evidence from 25 countries. Curr Psychol. 2023;42:845–54. doi:10.1007/s12144-021-01385-4.Google Scholar
Ogunbode, CA, Doran, R, Böhm, G. Exposure to the IPCC special report on 1.5 °C global warming is linked to perceived threat and increased concern about climate change. Clim Chang. 2020;158:361–75.Google Scholar
Cianconi, P, Betrò, S, Janiri, L. The impact of climate change on mental health: a systematic descriptive review. Front Psych. 2020;11:74. doi:10.3389/fpsyt.2020.00074.Google Scholar
Beaglehole, B, Mulder, RT, Frampton, CM, Boden, JM, Newton-Howes, G, Bell, CJ. Psychological distress and psychiatric disorder after natural disasters: systematic review and meta-analysis. Br J Psychiatry. 2018;213(6):716–22. doi:10.1192/bjp.2018.210.Google Scholar
Burke, SEL, Sanson, AV, Van Hoorn, J. The psychological effects of climate change on children. Curr Psychiatry Rep. 2018;20(5):35. doi:10.1007/s11920-018-0896-9.Google Scholar
Rataj, E, Kunzweiler, K, Garthus-Niegel, S. Extreme weather events in developing countries and related injuries and mental health disorders – a systematic review. BMC Public Health. 2016;16(1):1020. doi:10.1186/s12889-016-3692-7.Google Scholar
Jones, MK, Wootton, BM, Vaccaro, LD, Menzies, RG. The impact of climate change on obsessive compulsive checking concerns. Aust N Z J Psychiatry. 2012;46(3):265–70.Google Scholar
Berry, HL, Bowen, K, Kjellstrom, T. Climate change and mental health: a causal pathways framework. Int J Public Health. 2010;55(2):123–32. doi:10.1007/s00038-009-0112-0.Google Scholar
Baudon, P, Jachens, L. A scoping review of interventions for the treatment of eco-anxiety. Int J Environ Res Public Health. 2021;18(18):9636. doi:10.3390/ijerph18189636.Google Scholar
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. doi:10.1186/s13033-018-0210-6.Google Scholar
Lewandowski, RE, Clayton, SD, Olbrich, L, Sakshaug, JW, Wray, B, Schwartz, SEO, et al. Climate emotions, thoughts, and plans among US adolescents and young adults: a cross-sectional descriptive survey and analysis by political party identification and self-reported exposure to severe weather events. Lancet Planet Health. 2024;8(11):e879–93. doi:10.1016/S2542-5196(24)00229-8.Google Scholar
Tam, K-P, Chan, H-W, Clayton, S. Climate change anxiety in China, India, Japan, and the United States. J Environ Psychol. 2023;87:1–14.Google Scholar
Georgiou, I, Xekalakis, G, Parlalis, S. Impact of climate change on individuals with autism and the role of renewable energy. E3S Web Conf. 2025;60804001. doi:10.1051/e3sconf/202560804001.Google Scholar
Boyd, CP, Jamieson, J, Gibson, K, Duffy, M, Williamson, M, Parr, H. Eco-anxiety among regional Australian youth with mental health problems: a qualitative study. Early Interv Psychiatry. 2024;18(12):1022–31. doi:10.1111/eip.13549.Google Scholar
Woodland, L, Ratwatte, P, Phalkey, R, Gillingham, EL. Investigating the health impacts of climate change among people with pre-existing mental health problems: a scoping review. Int J Environ Res Public Health. 2023;20(8):5563. doi:10.3390/ijerph20085563.Google Scholar
Aktaş, MC, Ayhan, CH, Karan, E. The effect of climate crisis on bipolar disorder: a qualitative study about experiences of individuals diagnosed with bipolar disorder. Int J Soc Psychiatry. 2025;71(2):254–63. doi:10.1177/00207640241291521.Google Scholar
Trost, K, Ertl, V, König, J, Rosner, R, Comtesse, H. Climate change-related concerns in psychotherapy: therapists’ experiences and views on addressing this topic in therapy. BMC Psychol. 2024;12(1):192. doi:10.1186/s40359-024-01677-x.Google Scholar
Runfola, CD, Safer, DL. The role of eco-anxiety in the presentation of bulimia nervosa: a case report. J Eat Disord. 2024;12(1):164. doi:10.1186/s40337-024-01118-5.Google Scholar
Lawrance, EL, Thompson, R, Newberry Le Vay, J, Page, L, Jennings, N. The impact of climate change on mental health and emotional wellbeing: a narrative review of current evidence, and its implications. Int Rev Psychiatry. 2022a;34(5):443–98. doi:10.1080/09540261.2022.2128725.Google Scholar
Crandon, TJ, Dey, C, Scott, JG, Thomas, HJ, Ali, S, Charlson, FJ. The clinical implications of climate change for mental health. Nat Hum Behav. 2022;6(11):1474–81.Google Scholar
Taylor, S. Anxiety disorders, climate change, and the challenges ahead: introduction to the special issue. J Anxiety Disord. 2020;76:102313. doi:10.1016/j.janxdis.2020.102313.Google Scholar
Stokols, D, Misra, S, Runnerstrom, MG, Hipp, JA. Psychology in an age of ecological crisis: from personal angst to collective action. Am Psychol. 2009;64(3):181–93. doi:10.1037/a0014717.Google Scholar
Lawrance, EL, Jennings, N, Kioupi, V, Thompson, R, Diffey, J, Vercammen, A. Psychological responses, mental health, and sense of agency for the dual challenges of climate change and the COVID-19 pandemic in young people in the UK: an online survey study. Lancet Planet Health. 2022;6(9):e726–38. doi:10.1016/S2542-5196(22)00172-3.Google Scholar
Every-Palmer, S, McBride, S, Berry, H, Menkes, DB. Climate change and psychiatry. Aust N Z J Psychiatry. 2016;50(1):16–8. doi:10.1177/0004867415615946.Google Scholar
Tricco, AC, Lillie, E, Zarin, W, O’Brien, KK, Colquhoun, H, Levac, D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73. doi:10.7326/M18-0850.Google Scholar
Peters, MDJ, Godfrey, C, McInerney, P, Munn, Z, Tricco, AC, Khalil, H. Scoping reviews (2020 version). In: Aromataris, E, Munn, Z (Editors). JBI manual for evidence synthesis, JBI. 2020. https://synthesismanual.jbi.global. doi:10.46658/JBIMES-20-12Google Scholar
Hirt, J, Nordhausen, T, Fuerst, T, Ewald, H, Appenzeller-Herzog, C, TARCiS Study Group. Guidance on terminology, application, and reporting of citation searching: the TARCiS statement. BMJ. 2024;385:e078384. doi:10.1136/bmj-2023-078384. Erratum in: BMJ. 2024;387:q2458. doi:10.1136/bmj.q2458.Google Scholar
Owczarek, M, Redican, E, Shevlin, M, Nolan, E. Psychometric assessment of climate-related emotional responses: a systematic review of measures for eco-anxiety and related constructs. Curr Psychol. 2025;44:4883–905. doi:10.1007/s12144-025-07519-2.Google Scholar
Hannachi, T, Yakimova, S, Somat, A. A follow up on the continuum theory of eco-anxiety: analysis of the climate change anxiety scale using item response theory among French speaking population. Int J Environ Res Public Health. 2024;21(9):1158. doi:10.3390/ijerph21091158.Google Scholar
Chan, HW, Lin, L, Tam, KP, Hong, YY. From negative feelings to impairments: a longitudinal study on the development of climate change anxiety. J Anxiety Disord. 2024;107:102917. doi:10.1016/j.janxdis.2024.102917.Google Scholar
Wu, J, Long, D, Hafez, N, Maloney, J, Lim, Y, Samji, H. Development and validation of a youth climate anxiety scale for the youth development instrument survey. Int J Ment Health Nurs. 2023;32(6):1473–83. doi:10.1111/inm.13201.Google Scholar
Hepp, J, Klein, SA, Horsten, LK, Urbild, J, Lane, SP. Introduction and behavioural validation of the climate change distress and impairment scale. Sci Rep. 2023;13(1):11272. doi:10.1038/s41598-023-37573-4.Google Scholar
Asgarizadeh, Z, Gifford, R, Colborne, L. Predicting climate change anxiety. J Environmental Psychol. 2023;90:102087. doi:10.1016/j.jenvp.2023.102087.Google Scholar
Whitmarsh, L, Player, L, Jiongco, A, James, M, Williams, M, Marks, E, et al. Climate anxiety: what predicts it and how is it related to climate action? J Env Psych. 2022;83:101866. doi:10.1016/j.jenvp.2022.101866.Google Scholar
Lutz, PK, Passmore, H-A, Howell, AJ, Zelenski, JM, Yang, Y, Richardson, M. The continuum of eco-anxiety responses: a preliminary investigation of its nomological network. Collabra Psychol. 2023;9(1):67838.Google Scholar
Gago, T, Sá, I. Environmental worry and wellbeing in young adult university students. Curr Res Environ Sustain. 2021;3:100064. doi:10.1016/j.crsust.2021.100064.Google Scholar
Stewart, AE, Chapman, HE, Davis, JBL. Anxiety and worry about six categories of climate change impacts. Int J Environ Res Public Health. 2023;21(1):23. doi:10.3390/ijerph21010023.Google Scholar
Lau, SSS, Appiah, K, Ho, CCY, Cheng, MCH, Yang, B. Measuring Chinese negative emotion towards climate change: psychometric properties of the Chinese version of Climate Change Anxiety Scale. J Clim Chang Health. 2025;21:100364. doi:10.1016/j.joclim.2024.100364.Google Scholar
Avan, H, Vural, B. The relationship between climate change anxiety and depression and insomnia in adolescents. Child Youth Serv Rev. 2025;170:108138. doi:10.1016/j.childyouth.2025.108138.Google Scholar
Li, H, Bardhan, M, Liu, Q, Yang, Y, Yin, M, Zhang, X, et al. The pathways linking green spaces to reduced climate change anxiety. Urban For Urban Green. 2025;104:128600.Google Scholar
Cameron, EC, Kagee, A. Psychological, experiential, and behavioral predictors of climate change anxiety among South African university students. Trends Psychol. 2025;1–22. doi:10.1007/s43076-025-00444-0.Google Scholar
Yesildere Saglam, H, Mizrak Sahin, B. The impact of climate change anxiety on premenstrual syndrome: a cross-sectional study. J Eval Clin Pract. 2025;31(4):e14177. doi:10.1111/jep.14177.Google Scholar
Cosh, SM, Williams, SE, Lykins, AD, Bartik, W, Tully, PJ. Detecting and classifying eco-anxiety: development of clinical cut-off scores for the climate change anxiety scale. BMC Psychol. 2024;12(1):738. doi:10.1186/s40359-024-02240-4.Google Scholar
Shepherd, S, Raynal, P, Guedj, M. Psychometric properties of the French version of the climate change worry scale. J Clim Chang Health. 2024;20:100361. doi:10.1016/j.joclim.2024.100361.Google Scholar
Wagner, L, Witthöft, M. Klimaangst – angebracht oder dysfunktional? Eine Untersuchung des Zusammenhangs mit Depressivität, Ängstlichkeit und positiven klimabezogenen Verhaltensweisen. Z Klin Psychol Psychother. 2024;53(2):59–71. doi:10.1026/1616-3443/a000754.Google Scholar
Coates, Z, Kelly, M, Brown, S. The relationship between climate anxiety and pro-environment behaviours. Sustainability. 2024;16(12):5211. doi:10.3390/su16125211.Google Scholar
Chan, HW, Tam, KP, Clayton, S. Testing an integrated model of climate change anxiety. J Environ Psychol. 2024;97:102368. doi:10.1016/j.jenvp.2024.102368.Google Scholar
Becht, A, Spitzer, J, Grapsas, S, van de Wetering, J, Poorthuis, A, Smeekes, A, et al. Feeling anxious and being engaged in a warming world: climate anxiety and adolescents’ pro-environmental behavior. J Child Psychol Psychiatry. 2024;65(10):1270–82. doi:10.1111/jcpp.14035.Google Scholar
Larionow, P, Mackiewicz, J, Mudło-Głagolska, K, Michalak, M, Mazur, M, Gawrych, M, et al. Measuring eco-anxiety with the Polish version of the 13-item Hogg Eco-Anxiety Scale (HEAS-13): latent structure, correlates, and psychometric performance. Healthcare (Basel). 2024;12(22):2255. doi:10.3390/healthcare12222255.Google Scholar
Weiß, M, Gutzeit, J, Hein, G. Development and validation of the domain-specific climate change distress scale. J Environ Psychol. 2024;98:102392. doi:10.1016/j.jenvp.2024.102392.Google Scholar
Ali, M, Jahan, AM, Enaas, A. Investigating the impact of climate change on mental health among Libyan Arabs: a validation study of the Hogg Eco-Anxiety Scale. Curr Psychol. 2024;43:31789–801. doi:10.1007/s12144-024-06548-7.Google Scholar
Brailovskaia, J, Teismann, T. Climate change distress, entrapment, and suicidal ideation. Clim Chang. 2024;177:127. doi:10.1007/s10584-024-03784-5.Google Scholar
Pitron, V, Lemogne, C, Clayton, S, Léger, D, Van den Bergh, O, Witthöft, M. Climate change anxiety and its association with somatic symptom distress and idiopathic environmental intolerances: a cross-sectional study. J Psychosom Res. 2024;187:111937. doi:10.1016/j.jpsychores.2024.111937.Google Scholar
Tucholska, K, Gulla, B, Ziernicka-Wojtaszek, A. Climate change beliefs, emotions and pro-environmental behaviors among adults: the role of core personality traits and the time perspective. PLoS One. 2024;19(4):e0300246. doi:10.1371/journal.pone.0300246.Google Scholar
Hogg, TL, Stanley, SK, O’Brien, LV. Validation of the Hogg Climate Anxiety Scale. Clim Chang. 2024;177:86. doi:10.1007/s10584-024-03726-1.Google Scholar
Fekih-Romdhane, F, Malaeb, D, Yakın, E, Sakr, F, Dabbous, M, El Khatib, S, et al. Translation and validation to the Arabic language version of the climate change anxiety scale (CCAS). BMC Psychiatry. 2024;24(1):507. doi:10.1186/s12888-024-05956-0.Google Scholar
Carlson, JM, Foley, J, Fang, L. Climate change on the brain: neural correlates of climate anxiety. J Anxiety Disord. 2024;103:102848. doi:10.1016/j.janxdis.2024.102848.Google Scholar
Zeier, P, Wessa, M. Measuring eco-emotions: a German version of questionnaires on eco-guilt, ecological grief, and eco-anxiety. Discov Sustain. 2024;5:29. doi:10.1007/s43621-024-00209-2.Google Scholar
Fekih-Romdhane, F, Malaeb, D, Postigo, A, Sakr, F, Dabbous, M, Khatib, SE, et al. The relationship between climate change anxiety and psychotic experiences is mediated by death anxiety. Int J Soc Psychiatry. 2024;70(3):574–81. doi:10.1177/00207640231221102.Google Scholar
Çimşir, E, Şahin, MD, Akdoğan, R. Unveiling the relationships between eco-anxiety, psychological symptoms and anthropocentric narcissism: the psychometric properties of the Turkish version of the Hogg eco-anxiety scale. Glob Ment Health (Camb). 2024;11:e26. doi:10.1017/gmh.2024.20.Google Scholar
Veijonaho, S, Ojala, M, Hietajärvi, L, Salmela-Aro, K. Profiles of climate change distress and climate denialism during adolescence: a two-cohort longitudinal study. Int J Behav Dev. 2024;48(2):103–12. doi:10.1177/01650254231205251.Google Scholar
Orrù, L, Mannarini, S. Psychological impact of climate change emergency: an attempt to define eco-anxiety. Front Psychol. 2024;15:1375803. doi:10.3389/fpsyg.2024.1375803.Google Scholar
Lykins, AD, Bonich, M, Sundaraja, C, Cosh, S. Climate change anxiety positively predicts antenatal distress in expectant female parents. J Anxiety Disord. 2024;101:102801. doi:10.1016/j.janxdis.2023.102801.Google Scholar
Hogg, TL, Stanley, SK, O’Brien, LV, Watsford, CR, Walker, I. Clarifying the nature of the association between eco-anxiety, wellbeing and pro-environmental behavior. J Environ Psychol. 2024;95:102249. doi:10.1016/j.jenvp.2024.102249.Google Scholar
Wullenkord, MC, Johansson, M, Loy, LS, Menzel, C, Reese, G. Go out or stress out? Exploring nature connectedness and cumulative stressors as resilience and vulnerability factors in different manifestations of climate anxiety. J Environ Psychol. 2024;95:102278. doi:10.1016/j.jenvp.2024.102278.Google Scholar
Parmentier, ML, Weiss, K, Aroua, A, Betry, C, Rivière, M, Navarro, O. The influence of environmental crisis perception and trait anxiety on the level of eco-worry and climate anxiety. J Anxiety Disord. 2024;101:102799. doi:10.1016/j.janxdis.2023.102799.Google Scholar
Jalin, H, Sapin, A, Macherey, A, Boudoukha, AH, Congard, A. Understanding eco-anxiety: exploring relationships with environmental trait affects, connectedness to nature, depression, anxiety, and media exposure. Curr Psychol. 2024;43:23455–68.Google Scholar
Micoulaud-Franchi, JA, Coelho, J, Geoffroy, PA, Vecchierini, MF, Poirot, I, Royant-Parola, S, et al. Eco-anxiety: an adaptive behavior or a mental disorder? Results of a psychometric study. Encéphale. 2024;50(4):406–15. doi:10.1016/j.encep.2023.08.009.Google Scholar
Er, S, Murat, M, Ata, EE, Köse, S, Buzlu, S. Nursing students’ mental health: how does eco-anxiety effect? Int J Ment Health Nurs. 2024; doi:10.1111/inm.13320.Google Scholar
Nezlek, JB, Cypryańska, M. Relationships between climate change distress, generalized anxiety, and climate-related symptoms of mental disorders. Anxiety Stress Coping. 2024;37(5):545–57. doi:10.1080/10615806.2024.2332628.Google Scholar
Plohl, N, Mlakar, I, Musil, B, Smrke, U. Measuring young individuals’ responses to climate change: validation of the Slovenian versions of the climate anxiety scale and the climate change worry scale. Front Psychol. 2023;14:1297782. doi:10.3389/fpsyg.2023.1297782.Google Scholar
Patrick, R, Snell, T, Gunasiri, H, Garad, R, Meadows, G, Enticott, J. Prevalence and determinants of mental health related to climate change in Australia. Aust N Z J Psychiatry. 2023;57(5):710–24. doi:10.1177/00048674221107872.Google Scholar
Thomson, EE, Roach, SP. The relationships among nature connectedness, climate anxiety, climate action, climate knowledge, and mental health. Front Psychol. 2023;14:1241400. doi:10.3389/fpsyg.2023.1241400.Google Scholar
Ediz, Ç, Yanik, D. The effects of climate change awareness on mental health: comparison of climate anxiety and hopelessness levels in Turkish youth. Int J Soc Psychiatry. 2023;69(8):2157–66. doi:10.1177/00207640231206060.Google Scholar
Mathers-Jones, J, Todd, J. Ecological anxiety and pro-environmental behaviour: the role of attention. J Anxiety Disord. 2023;98:102745. doi:10.1016/j.janxdis.2023.102745.Google Scholar
Vercammen, A, Oswald, T, Lawrance, E. Psycho-social factors associated with climate distress, hope and behavioural intentions in young UK residents. PLOS Glob Public Health. 2023;3(8):e0001938. doi:10.1371/journal.pgph.0001938.Google Scholar
Heinzel, S, Tschorn, M, Schulte-Hutner, M, Schäfer, F, Reese, G, Pohle, C, et al. Anxiety in response to the climate and environmental crises: validation of the Hogg Eco-Anxiety Scale in Germany. Front Psychol. 2023;14:1239425. doi:10.3389/fpsyg.2023.1239425.Google Scholar
Lukacs, JN, Bratu, A, Adams, S, Logie, C, Tok, N, McCunn, LJ, et al. The concerned steward effect: exploring the relationship between climate anxiety, psychological distress, and self-reported climate related behavioural engagement. J Environ Psychol. 2023;90:102091. doi:10.1016/j.jenvp.2023.102091.Google Scholar
Mathé, M, Grisetto, F, Gauvrit, N, Roger, C. Psychometric validation of the French version of the Hogg Eco-Anxiety Scale (HEAS-FR). Can J Behav Sci. 2023;57(1):59–65. doi:10.1037/cbs0000398.Google Scholar
Innocenti, M, Perilli, A, Santarelli, G, Carluccio, N, Zjalic, D, Acquadro Maran, D, et al. How does climate change worry influence the relationship between climate change anxiety and eco-paralysis? A moderation study. Climate. 2023;11(9):190. doi:10.3390/cli11090190.Google Scholar
Heeren, A, Mouguiama-Daouda, C, Contreras, A. On climate anxiety and the threat it may pose to daily life functioning and adaptation: a study among European and African French-speaking participants. Clim Chang. 2022;173(1-2):15. doi:10.1007/s10584-022-03402-2.Google Scholar
Schwaab, L, Gebhardt, N, Friederich, HC, Nikendei, C. Climate change related depression, anxiety and stress symptoms perceived by medical students. Int J Environ Res Public Health. 2022;19(15):9142. doi:10.3390/ijerph19159142.Google Scholar
Feather, G, Williams, M. The moderating effects of psychological flexibility and psychological inflexibility on the relationship between climate concern and climate-related distress. J Contextual Behav Sci. 2022;23:137–43. doi:10.1016/j.jcbs.2021.12.007.Google Scholar
Hajek, A, König, H-H. Climate anxiety and mental health in Germany. Climate. 2023;11(8):158. doi:10.3390/cli11080158.Google Scholar
Hajek, A, König, HH. Climate anxiety, loneliness and perceived social isolation. Int J Environ Res Public Health. 2022;19(22):14991. doi:10.3390/ijerph192214991.Google Scholar
Mouguiama-Daouda, C, Blanchard, MA, Coussement, C, Heeren, A. On the measurement of climate change anxiety: French validation of the Climate Anxiety Scale. Psychol Belg. 2022;62(1):123–35. doi:10.5334/pb.1137.Google Scholar
Larionow, P, Sołtys, M, Izdebski, P, Mudło-Głagolska, K, Golonka, J, Demski, M, et al. Climate change anxiety assessment: the psychometric properties of the Polish Version of the Climate Anxiety Scale. Front Psychol. 2022;13:870392. doi:10.3389/fpsyg.2022.870392.Google Scholar
Cruz, SM, High, AC. Psychometric properties of the climate change anxiety scale. J Environ Psychol. 2022;84:101905.Google Scholar
Wullenkord, MC, Tröger, J, Hamann, KRS, Loy, LS, Reese, G. Anxiety and climate change: a validation of the Climate Anxiety Scale in a German-speaking quota sample and an investigation of psychological correlates. Clim Chang. 2021;168:20. doi:10.1007/s10584-021-03234-6.Google Scholar
Hogg, TL, Stanley, SK, O’Brien, LV, Wilson, MS, Watsford, CR. The Hogg eco-anxiety scale: development and validation of a multidimensional scale. Glob Environ Chang. 2021;71:102391. doi:10.1016/j.gloenvcha.2021.102391.Google Scholar
Innocenti, M, Santarelli, G, Faggi, V, Castellini, G, Manelli, I, Magrini, G, et al. Psychometric properties of the Italian version of the Climate Change Anxiety Scale. J Clim Change Health. 2021;3:100080. doi:10.1016/j.joclim.2021.100080.Google Scholar
Clayton, S, Karazsia, BT. Development and validation of a measure of climate change anxiety. J Environ Psychol. 2020;69:101434.Google Scholar
Lerolle, A, Micoulaud-Franchi, JA, Fourneret, P, Heeren, A, Gauld, C. Exploring the relationship between eco-anxiety and suicide risk in adolescents with mental health disorders: insights from a cross-sectional observational study. Front Psychol. 2025;15:1408835. doi:10.3389/fpsyg.2024.1408835.Google Scholar
Gebhardt, N, Schwaab, L, Friederich, HC, Nikendei, C. The relationship of climate change awareness and psychopathology in persons with pre-existing mental health diagnoses. Front Psych. 2023;14:1274523. doi:10.3389/fpsyt.2023.1274523.Google Scholar
Knowles, KA, Olatunji, BO. Specificity of trait anxiety in anxiety and depression: meta-analysis of the State-Trait Anxiety Inventory. Clin Psychol Rev. 2020;82:101928. doi:10.1016/j.cpr.2020.101928.Google Scholar
Gago, T, Sargisson, RJ, Milfont, TL. A meta-analysis on the relationship between climate anxiety and wellbeing. J Environ Psychol. 2024;94:102230. doi:10.1016/j.jenvp.2024.102230.Google Scholar
Cosh, SM, Ryan, R, Fallander, K, Robinson, K, Tognela, J, Tully, PJ, et al. 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. BMC Psychiatry. 2024;24(1):833. doi:10.1186/s12888-024-06274-1.Google Scholar
Hogg, TL, Stanley, SK, O’Brien, LV. Synthesising psychometric evidence for the Climate Anxiety Scale and Hogg Eco-Anxiety Scale. J Environ Psychol. 2023;88:102003. doi:10.1016/j.jenvp.2023.Google Scholar
Sampaio, F, Sequeira, C. Climate anxiety: trigger or threat for mental disorders? Lancet Planet Health. 2022;6(2):e89. doi:10.1016/S2542-5196(22)00008-0. PMID: 35150633.Google Scholar
Searle, KA, Gow, KM. Do concerns about climate change lead to distress. Int J Clim Chang Strateg Manag. 2010;2:362–79.Google Scholar
Vukičević, T, Liu, S. Diagnosing climate anxiety? Environmental mental health challenges. Lancet Planet Health. 2024;8(6):e349. doi:10.1016/S2542-5196(24)00091-3.Google Scholar
Butler, CD, Rao, M. What “dose” of anxiety is needed to awaken transformative action on climate change? BMJ. 2025;388:q2584. doi:10.1136/bmj.q2584. PMID: 39794004.Google Scholar
Pitt, C, Norris, K, Pecl, G. Informing future directions for climate anxiety interventions: a mixed-method study of professional perspectives. J Outdoor Environ Educ. 2024;27:209–34. doi:10.1007/s42322-023-00156-y.Google Scholar
Hurley, EA, Dalglish, SL, Sacks, E. Supporting young people with climate anxiety: mitigation, adaptation, and resilience. Lancet Planet Health. 2022;6(3):e190.Google Scholar
Crandon, TJ, Scott, JG, Charlson, FJ, Thomas, HJ. A social–ecological perspective on climate anxiety in children and adolescents. Nat Clim Chang. 2022;12:123–31. doi:10.1038/s41558-021-01251-y.Google Scholar
Climate Psychological Alliance. Handbook of climate psychology. 2022. https://www.climatepsychologyalliance.org/images/files/handbookofclimatepsychology.pdf.Google Scholar
Thoma, MV, Rohleder, N, Rohner, SL. Clinical ecopsychology: the mental health impacts and underlying pathways of the climate and environmental crisis. Front Psych. 2021;12:675936. doi:10.3389/fpsyt.2021.675936.Google Scholar
Cunsolo, A, Harper, SL, Minor, K, Hayes, K, Williams, KG, Howard, C. Ecological grief and anxiety: the start of a healthy response to climate change? Lancet Planet Health. 2020;4(7):e261–3. doi:10.1016/S2542-5196(20)30144-3.Google Scholar
Panu, P. Anxiety and the ecological crisis: an analysis of eco-anxiety and climate anxiety. Sustainability. 2020;12(19):7836. doi:10.3390/su12197836.Google Scholar
Verplanken, B, Roy, D. “My worries are rational, climate change is not”: habitual ecological worrying is an adaptive response. PLoS One. 2013;8(9):e74708.Google Scholar
Dodds, J. The psychology of climate anxiety. BJPsych Bull. 2021;45(4):222–6. doi:10.1192/bjb.2021.18.Google Scholar
Passmore, HA, Lutz, PK, Howell, AJ. Eco-anxiety: a cascade of fundamental existential anxieties. J Constr Psychol. 2023;36(2):138–53.Google Scholar
Ramadan, AMH, Ataallah, AG. Are climate change and mental health correlated? Gen Psychiatr. 2021;34(6):e100648.Google Scholar
Hajek, A, König, HH. Climate anxiety in Germany. Public Health. 2022;212:89–94. doi:10.1016/j.puhe.2022.09.007.Google Scholar
Laing, RD. The divided self: an existential study in sanity and madness. London: Tavistock; 1960.Google Scholar
Magruder, KJ, Chipman, SJ. From eco-anxiety to eco-resilience: how ACT can counter environmental injustice and advance human rights. J Hum Rights Soc Work. 2025; doi:10.1007/s41134-024-00350-y.Google Scholar
Christodoulou, N, Laaidi, K, Geoffroy, PA. Eco-anxiety: towards a medical model and the new framework of ecolalgia. Bipolar Disord. 2024;26(6):532–47. doi:10.1111/bdi.13446.Google Scholar
Ballew, MT, Uppalapati, SS, Myers, T, Carman, J, Campbell, E, Rosenthal, SA, et al. Climate change psychological distress is associated with increased collective climate action in the U.S. npj Clim Action. 2024;3(88): doi:10.1038/s44168-024-00172-8.Google Scholar
Gregersen, T, Doran, R, Ogunbode, CA, Böhm, G. How the public understands and reacts to the term “climate anxiety”. J Environ Psychol. 2024;96:102340. doi:10.1016/j.jenvp.2024.102340.Google Scholar
Babbott, M. Pretraumatic climate stress in psychotherapy: an integrated case illustration. Ecopsychology. 2023;15(4):312–21.Google Scholar
Raile, P. The importance of teaching climate-health literacy in psychotherapeutic training and continuing education. F1000Res. 2024;12:982. doi:10.12688/f1000research.139879.2.Google Scholar
Lawton, G. What is eco-anxiety? New Sci. 2024;262(3485):36. doi:10.1016/S0262-4079(24)00653-5.Google Scholar
Budziszewska, M, Jonsson, SE. Talking about climate change and eco-anxiety in psychotherapy: a qualitative analysis of patients’ experiences. Psychotherapy (Chic). 2022;59(4):606–15. doi:10.1037/pst0000449.Google Scholar
Bahar, L, Rego, SA, Sadeh-Sharvit, S. Detecting climate anxiety in therapy through natural language processing. Sci Rep. 2024;14(1):25976. doi:10.1038/s41598-024-75269-5.Google Scholar
Brandt, L, Adorjan, K, Catthoor, K, Chkonia, E, Falkai, P, Fiorillo, A, et al. Climate change and mental health: position paper of the European Psychiatric Association. Eur Psychiatry. 2024;23:1–34. doi:10.1192/j.eurpsy.2024.1754.Google Scholar
Ursano, RJ, Morganstein, JC, Cooper, R. Position statement on mental health and climate change. American Psychiatric Association. https://www.psychiatry.org/getattachment/0ce71f37-61a6-44d0-8fcd-c752b7e935fd/Position-Mental-Health-Climate-Change.pdf.Google Scholar
Vidal, C, Latkin, C. Views of psychiatrists and psychiatry trainees on climate change: distress, training needs, and envisioned role. Acad Psychiatry. 2024;48(4):351–6. doi:10.1007/s40596-024-01987-7.Google Scholar
Doherty, TJ, Clayton, S. The psychological impacts of global climate change. Am Psychol. 2011;66(4):265–76. doi:10.1037/a0023141.Google Scholar
Wardle, A. Nature-based art therapy: supporting children’s emotional regulation and responses to the climate crisis. Int J Art Ther. 2025;30(1):28–35. doi:10.1080/17454832.2024.2382955.Google Scholar
Reininghaus, U. Feasibility of a digital training for mental health promotion in young people with climate change related distress. 2025 ISRCTN33613914. https://www.isrctn.com/ISRCTN33613914.Google Scholar
van Dijk, S, van Schie, K, Smeets, T, Mertens, G. Limited consensus on what climate anxiety is: insights from content overlap analysis on 12 questionnaires. J Anxiety Disord. 2025;109:102957. doi:10.1016/j.janxdis.2024.102957.Google Scholar
Jarrett, J, Gauthier, S, Baden, D, Ainsworth, B, Dorey, L. Eco-anxiety and climate-anxiety linked to indirect exposure: a scoping review of empirical research. J Environ Psychol. 2024;96:102326. doi:10.1016/j.jenvp.2024.102326.Google Scholar
Hunt, M, Auriemma, J, Cashaw, AC. Self-report bias and underreporting of depression on the BDI-II. J Pers Assess. 2003;80(1):26–30. doi:10.1207/S15327752JPA8001_10.Google Scholar
Ogunbode, CA, Doran, R, Hanss, D, Ojala, M, Salmela-Aro, K, van den Broek, KL, et al. Climate anxiety, wellbeing and pro-environmental action: correlates of negative emotional responses to climate change in 32 countries. J Environ Psychol. 2022;84:101887. doi:10.1016/j.jenvp.2022.101887.Google Scholar
Figure 0

Table 1. Inclusion and exclusion criteria of studies

Figure 1

Figure 1. PRISMA flowchart.

Figure 2

Table 2. Study and patient characteristics of studies in general population individuals with subclinical symptoms or mental diagnoses [6, 18, 43, 50–55, 58–112]

Figure 3

Table 3. Results of studies in general population individuals with subclinical symptoms or mental diagnoses [6, 18, 43, 50–55, 58–112]

Figure 4

Table 4. Results of studies in the clinical population [27, 113, 114]

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