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Brandt L, Heinz A. [Climate crisis and psychiatry]. DER NERVENARZT 2024; 95:1005-1012. [PMID: 39186108 DOI: 10.1007/s00115-024-01735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND The climate crisis is increasingly leading to negative consequences for mental health and is of growing importance for psychiatric and psychotherapeutic care. OBJECTIVE The effects of the climate crisis on mental health and its significance for psychiatric and psychotherapeutic care are presented. Recommendations for sustainability in psychiatric and psychotherapeutic practice are provided. MATERIAL AND METHODS A narrative review of the literature was conducted for this article. RESULTS The climate crisis has direct, indirect and intersectional negative effects on mental health. Sustainable and preventive recommendations for the practice include promoting health literacy, faster access to psychotherapy and online counselling, supporting social networks, promoting employment and reducing poverty, homelessness and social isolation. It is recommended to increase the proportion of outpatient care and to streamline administrative processes. The use of disposable products should be minimized and the application of instrumental diagnostics and materials should be optimized according to guidelines. Digital interventions should be considered more frequently in the clinical practice and sustainable facility management should be improved. Access to green spaces for the general population and patients should be facilitated. CONCLUSION Due to the negative impact of the climate crisis on mental health, sustainability should be promoted in psychiatric and psychotherapeutic care.
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Affiliation(s)
- Lasse Brandt
- Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Charitéplatz 1, 10117, Berlin, Deutschland
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort Berlin-Potsdam, Deutschland
| | - Andreas Heinz
- Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Charitéplatz 1, 10117, Berlin, Deutschland.
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort Berlin-Potsdam, Deutschland.
- Bernstein Center of Computational Neuroscience Berlin, Berlin, Deutschland.
- Berlin School of Mind and Brain, Berlin, Deutschland.
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Werder E, Lawrence K, Deng X, Braxton Jackson W, Christenbury K, Buller I, Engel L, Sandler D. Residential air pollution, greenspace, and adverse mental health outcomes in the U.S. Gulf Long-term Follow-up Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174434. [PMID: 38960154 PMCID: PMC11332601 DOI: 10.1016/j.scitotenv.2024.174434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/06/2024] [Accepted: 06/30/2024] [Indexed: 07/05/2024]
Abstract
Air pollution and greenness are environmental determinants of mental health, though existing evidence typically considers each exposure in isolation. We evaluated relationships between co-occurring air pollution and greenspace levels and depression and anxiety. We estimated cross-sectional associations among 9015 Gulf Long-term Follow-up Study participants living in the southeastern U.S. who completed the Patient Health Questionnaire-9 (depression: score ≥ 10) and Generalized Anxiety Disorder Questionnaire-7 (anxiety: score ≥ 10). Participant residential addresses were linked to annual average concentrations of particulate matter (1 km PM2.5) and nitrogen dioxide (1 km NO2), as well as satellite-based greenness (2 km Enhanced Vegetation Index (EVI)). We used adjusted log-binomial regression to estimate prevalence ratios (PR) and 95 % confidence intervals (CI) for associations between exposures (quartiles) and depression and anxiety. In mutually adjusted models (simultaneously modeling PM2.5, NO2, and EVI), the highest quartile of PM2.5 was associated with increased prevalence of depression (PR = 1.17, 95 % CI: 1.06-1.29), whereas the highest quartile of greenness was inversely associated with depression (PR = 0.89, 95 % CI: 0.80-0.99). Joint exposure to greenness mitigated the impact of PM2.5 on depression (PRPM only = 1.20, 95 % CI: 1.06-1.36; PRPM+green = 0.98, 95 % CI: 0.83-1.16) and anxiety (PRPM only = 1.10, 95 % CI: 1.00-1.22; PRPM+green = 0.95, 95 % CI: 0.83-1.09) overall and in subgroup analyses. Observed associations were stronger in urbanized areas and among nonwhite participants, and varied by neighborhood deprivation. NO2 exposure was not independently associated with depression or anxiety in this population. Relationships between PM2.5, greenness, and depression were strongest in the presence of characteristics that are highly correlated with lower socioeconomic status, underscoring the need to consider mental health as an environmental justice issue.
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Affiliation(s)
| | | | | | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Kate Christenbury
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Ian Buller
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Lawrence Engel
- Epidemiology Branch, NIEHS, NC, USA; Department of Epidemiology, UNC Gillings School of Public Health, NC, USA
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Heinz A, Brandt L. Climate change and mental health: direct, indirect, and intersectional effects. THE LANCET REGIONAL HEALTH. EUROPE 2024; 43:100969. [PMID: 39210948 PMCID: PMC11360162 DOI: 10.1016/j.lanepe.2024.100969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Germany
- German Center for Mental Health (DZPG), partner site Berlin-Potsdam, Germany
- Bernstein Center of Computational Neuroscience Berlin, Germany
- Berlin School of Mind and Brain, Germany
| | - Lasse Brandt
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Germany
- German Center for Mental Health (DZPG), partner site Berlin-Potsdam, Germany
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Brandt L, Adorjan K, Catthoor K, Chkonia E, Falkai P, Fiorillo A, Gondek TM, Le Vay JN, Rojnic M, Meyer-Lindenberg A, Heinz A, Dom G, Luykx JJ. Climate change and mental health: Position paper of the European Psychiatric Association. Eur Psychiatry 2024; 67:e41. [PMID: 38778031 PMCID: PMC11441337 DOI: 10.1192/j.eurpsy.2024.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Climate change is one of the greatest threats to health that societies face and can adversely affect mental health. Given the current lack of a European consensus paper on the interplay between climate change and mental health, we signal a need for a pan-European position paper about this topic, written by stakeholders working in mental health care. METHODS On behalf of the European Psychiatric Association (EPA), we give recommendations to make mental health care, research, and education more sustainable based on a narrative review of the literature. RESULTS Examples of sustainable mental healthcare comprise preventive strategies, interdisciplinary collaborations, evidence-based patient care, addressing social determinants of mental health, maintaining health services during extreme weather events, optimising use of resources, and sustainable facility management. In mental health research, sustainable strategies include investigating the impact of climate change on mental health, promoting research on climate change interventions, strengthening the evidence base for mental health-care recommendations, evaluating the allocation of research funding, and establishing evidence-based definitions and clinical approaches for emerging issues such as 'eco-distress'. Regarding mental health education, planetary health, which refers to human health and how it is intertwined with ecosystems, may be integrated into educational courses. CONCLUSIONS The EPA is committed to combat climate change as the latter poses a threat to the future of mental health care. The current EPA position paper on climate change and mental health may be of interest to a diverse readership of stakeholders, including clinicians, researchers, educators, patients, and policymakers.
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Affiliation(s)
- Lasse Brandt
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Mental Health (DZPG), Germany
| | - Kristina Adorjan
- German Center for Mental Health (DZPG), Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kirsten Catthoor
- Estates-General of Mental Health, Kortenberg, Belgium
- Flemish Association of Psychiatry, Kortenberg, Belgium
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
- Ziekenhuis Netwerk Antwerpen, Psychiatrisch Ziekenhuis Stuivenberg, Antwerp, Belgium
| | - Eka Chkonia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Peter Falkai
- German Center for Mental Health (DZPG), Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Andrea Fiorillo
- Department of Mental Health, Collaborating Centre for Research and Training, University of Campania “L. Vanvitelli” & WHO, Naples, Italy
| | | | - Jessica Newberry Le Vay
- Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, London, UK
- Grantham Institute - Climate Change and the Environment, Faculty of Natural Sciences, Imperial College London, London, UK
| | - Martina Rojnic
- University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Andreas Meyer-Lindenberg
- German Center for Mental Health (DZPG), Germany
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Mental Health (DZPG), Germany
- Bernstein Center of Computational Neuroscience, Berlin, Germany
- Berlin School of Mind and Brain, Berlin, Germany
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
- Faculty of Medicine and Social Sciences, University of Antwerp, Wilrijk, Belgium
| | - Jurjen J. Luykx
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Outpatient Bipolar Disorders Clinic, GGZ InGeest Mental Healthcare, Amsterdam, The Netherlands
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Bolte G, Dandolo L, Gepp S, Hornberg C, Lumbi SL. Climate change and health equity: A public health perspective on climate justice. JOURNAL OF HEALTH MONITORING 2023; 8:3-35. [PMID: 38105794 PMCID: PMC10722520 DOI: 10.25646/11772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/05/2023] [Indexed: 12/19/2023]
Abstract
Background The discourse on climate justice has developed from the theoretical approaches and discussions on environmental justice. A central tenet of the concept of environmental and climate justice is that environmental and climate issues cannot be seen in isolation from issues of social justice. Methods A conceptual model was developed on the relationship between climate change impacts, social dimensions, adaptive capacities, biological sensitivity, and health equity in order to systematically analyse climate justice. Based on an exploratory literature review and the evaluation of the individual contributions of the status report on climate change and health, the evidence in Germany on social inequalities in exposure to climate change impacts and vulnerability to their direct and indirect health effects was summarised. Results This paper provides an overview of the international debate and examples of evidence on climate justice in Germany. Climate justice in the sense of avoidable, unjust social inequalities in exposure, vulnerability, and the effects of climate mitigation and adaptation measures on health inequalities is still insufficiently addressed in Germany. Conclusions A consistent integration of equity issues into climate policy is necessary. With reference to the international literature, options for action and research needs are identified.
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Affiliation(s)
- Gabriele Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
| | - Lisa Dandolo
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
| | - Sophie Gepp
- Centre for Planetary Health Policy, Berlin, Germany
| | - Claudia Hornberg
- Bielefeld University, Medical School OWL, Sustainable Environmental Health Sciences, Bielefeld, Germany
| | - Susanne Lopez Lumbi
- Bielefeld University, Medical School OWL, Sustainable Environmental Health Sciences, Bielefeld, Germany
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Arango C. Child maltreatment should be a priority for public mental health interventions. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01643-5. [PMID: 37449997 DOI: 10.1007/s00406-023-01643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Affiliation(s)
- Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, IiGSM, CIBERSAM, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, C/Ibiza, 43, 28009, Madrid, Spain.
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