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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085563. [PMID: 37107845 PMCID: PMC10138675 DOI: 10.3390/ijerph20085563] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
Climate change is the greatest threat to global public health, although the impacts on mental health are relatively understudied. Furthermore, there is a lack of consensus about the effects of climate change on individuals with pre-existing mental health problems. This review aimed to identify the health impacts of climate change on people with pre-existing mental health problems. The search was conducted across three databases; studies were included if they involved participants who had mental health problem(s) before a climate-driven event and reported on health outcomes post-event. A total of thirty-one studies met the full inclusion criteria. The study characteristics included 6 climate-driven events: heat events, floods, wildfires, wildfire and flood, hurricanes, and droughts, and 16 categories of pre-existing mental health problems, with depression, and non-specified mental health problems being the most common. The majority of the studies (90%, n = 28) suggest an association between the presence of pre-existing mental health problems and the likelihood of adverse health impacts (e.g., increased mortality risk, new symptom presentation, and an exacerbation of symptoms). To mitigate the exacerbation of health inequalities, people with pre-existing mental health problems should be included in adaption guidance and/or plans that mitigate the health impacts of climate change, future policy, reports, and frameworks.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London SE5 9RJ, UK
- Correspondence:
| | - Priyanjali Ratwatte
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Revati Phalkey
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| | - Emma L. Gillingham
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
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2
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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3
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Crane K, Li L, Subramanian P, Rovit E, Liu J. Climate Change and Mental Health: A Review of Empirical Evidence, Mechanisms and Implications. ATMOSPHERE 2022; 13:2096. [PMID: 37727770 PMCID: PMC10508914 DOI: 10.3390/atmos13122096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Anthropogenic climate change is an existential threat whose influences continue to increase in severity. It is pivotal to understand the implications of climate change and their effects on mental health. This integrative review aims to summarize the relevant evidence examining the harm climate change may have on mental health, suggest potential mechanisms and discuss implications. Empirical evidence has begun to indicate that negative mental health outcomes are a relevant and notable consequence of climate change. Specifically, these negative outcomes range from increased rates of psychiatric diagnoses such as depression, anxiety and post-traumatic stress disorder to higher measures of suicide, aggression and crime. Potential mechanisms are thought to include neuroinflammatory responses to stress, maladaptive serotonergic receptors and detrimental effects on one's own physical health, as well as the community wellbeing. While climate change and mental health are salient areas of research, the evidence examining an association is limited. Therefore, further work should be conducted to delineate exact pathways of action to explain the mediators and mechanisms of the interaction between climate change and mental health.
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Affiliation(s)
- Katelin Crane
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Linda Li
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, CA 90095, USA
| | - Pearl Subramanian
- Donald and Barbara Zucker School of Medicine, Hempstead, NY 11549, USA
| | - Elizabeth Rovit
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
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4
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Response to the Letter to the Editor "Psychiatry's undeclared identity crisis in a changing world" by Richard Skaff. CNS Spectr 2022; 27:555-556. [PMID: 34053472 DOI: 10.1017/s1092852921000559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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5
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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 2022; 34:443-498. [PMID: 36165756 DOI: 10.1080/09540261.2022.2128725] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales.
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Affiliation(s)
- Emma L Lawrance
- Institute of Global Health Innovation, Imperial College London, UK.,Mental Health Innovations, UK.,Grantham Institute of Climate and the Environment, Imperial College London, UK
| | | | | | - Lisa Page
- Brighton & Sussex Medical School, UK
| | - Neil Jennings
- Grantham Institute of Climate and the Environment, Imperial College London, UK
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Hwong AR, Wang M, Khan H, Chagwedera DN, Grzenda A, Doty B, Benton T, Alpert J, Clarke D, Compton WM. Climate change and mental health research methods, gaps, and priorities: a scoping review. Lancet Planet Health 2022; 6:e281-e291. [PMID: 35278392 DOI: 10.1016/s2542-5196(22)00012-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/29/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
Research on climate change and mental health is a new but rapidly growing field. To summarise key advances and gaps in the current state of climate change and mental health studies, we conducted a scoping review that comprehensively examined research methodologies using large-scale datasets. We identified 56 eligible articles published in Embase, PubMed, PsycInfo, and Web of Science between Jan 1, 2000, and Aug 9, 2020. The primary data collection method used was surveys, which focused on self-reported mental health effects due to acute and subacute climate events. Other approaches used administrative health records to study the effect of environmental temperature on hospital admissions for mental health conditions, and national vital statistics to assess the relationship between environmental temperature and suicide rates with regression analyses. Our work highlights the need to link population-based mental health outcome databases to weather data for causal inference. Collaborations between mental health providers and data scientists can guide the formation of clinically relevant research questions on climate change.
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Affiliation(s)
- Alison R Hwong
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA; National Clinician Scholars Program, UCSF and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
| | - Margaret Wang
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
| | - Hammad Khan
- Department of Psychiatry, University of California Davis, Davis, CA, USA
| | - D Nyasha Chagwedera
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Adrienne Grzenda
- Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin Doty
- American Psychiatric Association, Washington, DC, USA
| | - Tami Benton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Jonathan Alpert
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Diana Clarke
- American Psychiatric Association, Washington, DC, USA
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7
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Sugg MM, Runkle JD, Hajnos SN, Green S, Michael KD. Understanding the concurrent risk of mental health and dangerous wildfire events in the COVID-19 pandemic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150391. [PMID: 34844328 PMCID: PMC8455091 DOI: 10.1016/j.scitotenv.2021.150391] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 05/31/2023]
Abstract
Little research has examined the mental health risks of concurrent disasters. For example, disasters like wildfires have been shown to have a strong association with psychological symptoms-the 2020 U.S. Western wildfire season was the worst on record and occurred while the country was still navigating the COVID-19 pandemic. We implemented two quasi-experimental analyses, an interrupted time series analysis, and a difference-in-difference analysis to evaluate the impacts of wildfires and COVID-19 on mental health crisis help-seeking patterns. Both methods showed no statistical association between exposure to wildfires and the seeking of mental health support during the COVID-19 pandemic. Results highlighted that 2020 wildfires were not associated with an acute increase in crisis texts for youth in the two months after the events, likely due to an already elevated text volume in response to the COVID-19 pandemic from March 2020 throughout the fall wildfire season (Aug to Oct 2020). Future research is needed outside of the context of the pandemic to understand the effects of extreme and concurrent climatic events on adolescent mental health, and targeted interventions are required to ensure youth and adolescents are receiving adequate support during these types of crisis events.
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Affiliation(s)
- Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32109, Boone, NC 28608, United States.
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC 28801, United States.
| | - Sarah N Hajnos
- Department of Geography and Planning, Appalachian State University, P.O. Box 32109, Boone, NC 28608, United States
| | - Shannon Green
- Crisis Text Line, 24 W. 25th St, 6th Floor, New York, NY 10010, United States
| | - Kurt D Michael
- Department of Psychology, Appalachian State University, P.O. Box 32109, Boone, NC 28608, United States
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Analysis of features of social anxiety and exploring the relationship between childhood major adverse experiences and social anxiety in early adulthood among Chinese college students. J Affect Disord 2021; 292:614-622. [PMID: 34153832 DOI: 10.1016/j.jad.2021.05.105] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Prior studies have explored the prevalence of social anxiety disorders and found that childhood major adverse experiences increased the risk of social anxiety. However, few studies analyzed features of social anxiety and explored the mediation mechanism of the relationship between childhood major adverse experiences and social anxiety in early adulthood. METHODS Two thousand seven hundred and fifty-nine college students from Hunan, China participated in the survey-based study. They completed questionnaires on major adverse childhood experiences, social anxiety symptoms, and a sense of security during a study conducted from 2017 to 2018. RESULTS 1) 33.38% of the students reported experiencing at least one social anxiety symptom; the highest detection rate (20.22%) was social anxiety symptoms related to participants' nervousness when in large groups. 2) Females and individuals who consumed alcohol in the past year and individuals with a poor physical condition had a significantly higher risk of having social anxiety symptoms (p<0.05). 3) Childhood major adverse events experience increased the risk of some social anxiety symptoms, especially experiencing 3 or more adverse events (p<0.05). 4) A sense of security mediated the relationship between childhood major adverse events experience and social anxiety symptoms. CONCLUSIONS Extensive detection rate of social anxiety symptoms existed among college students, early adversities increased the risk of social anxiety in early adulthood, and the relationship between childhood major adversity and social anxiety was affected by sense of security.
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Marazziti D, Cianconi P, Mucci F, Foresi L, Chiarantini I, Della Vecchia A. Climate change, environment pollution, COVID-19 pandemic and mental health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145182. [PMID: 33940721 PMCID: PMC7825818 DOI: 10.1016/j.scitotenv.2021.145182] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 05/06/2023]
Abstract
Converging data would indicate the existence of possible relationships between climate change, environmental pollution and epidemics/pandemics, such as the current one due to SARS-CoV-2 virus. Each of these phenomena has been supposed to provoke detrimental effects on mental health. Therefore, the purpose of this paper was to review the available scientific literature on these variables in order to suggest and comment on their eventual synergistic effects on mental health. The available literature report that climate change, air pollution and COVID-19 pandemic might influence mental health, with disturbances ranging from mild negative emotional responses to full-blown psychiatric conditions, specifically, anxiety and depression, stress/trauma-related disorders, and substance abuse. The most vulnerable groups include elderly, children, women, people with pre-existing health problems especially mental illnesses, subjects taking some types of medication including psychotropic drugs, individuals with low socio-economic status, and immigrants. It is evident that COVID-19 pandemic uncovers all the fragility and weakness of our ecosystem, and inability to protect ourselves from pollutants. Again, it underlines our faults and neglect towards disasters deriving from climate change or pollution, or the consequences of human activities irrespective of natural habitats and constantly increasing the probability of spillover of viruses from animals to humans. In conclusion, the psychological/psychiatric consequences of COVID-19 pandemic, that currently seem unavoidable, represent a sharp cue of our misconception and indifference towards the links between our behaviour and their influence on the "health" of our planet and of ourselves. It is time to move towards a deeper understanding of these relationships, not only for our survival, but for the maintenance of that balance among man, animals and environment at the basis of life in earth, otherwise there will be no future.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy; UniCamillus - Saint Camillus University of Health Sciences, Rome, Italy
| | - Paolo Cianconi
- Institute of Psychiatry, Department of Neurosciences, Catholic University, Rome, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy; Department of Psychiatry, North-Western Tuscany Region, NHS Local Health Unit, Italy
| | - Lara Foresi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Ilaria Chiarantini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Alessandra Della Vecchia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy.
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Hrabok M, Delorme A, Agyapong VIO. Threats to Mental Health and Well-Being Associated with Climate Change. J Anxiety Disord 2020; 76:102295. [PMID: 32896782 DOI: 10.1016/j.janxdis.2020.102295] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023]
Abstract
Climate change is a contributor to extreme weather events and natural disasters. The mental health effects of climate change are multifaceted, with post-traumatic stress disorder and depression predominant. This paper aims to describe the impact of climate change on mental health conditions, including risk and protective factors related to the expression of mental health conditions post-disaster, as well as a discussion of our local experience with a devastating wildfire to our region within Canada. The risk of the development of mental health conditions post-disaster is not equally distributed; research has consistently demonstrated that specific risk factors (e.g., gender, socioeconomic status and education, pre-existing mental health symptomatology), are associated with increased vulnerability to mental health conditions following natural disasters. There are multiple strategies that must be undertaken by communities to enhance adjustment and coping post-disaster, including improved access to care, inter-agency cooperation, enhanced community resiliency, and adequate preparation.
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Affiliation(s)
- Marianne Hrabok
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aaron Delorme
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent I O Agyapong
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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Marko T, Suarez M, Todorova E, Mark C, Julie P. A Scoping Review of Nurses' Contributions to Health-Related, Wildfire Research. ANNUAL REVIEW OF NURSING RESEARCH 2020; 38:73-96. [PMID: 32102956 DOI: 10.1891/0739-6686.38.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Exposure to unprecedented levels of wildfire smoke is increasing cardiopulmonary mortality and is especially catastrophic to people with preexisting respiratory conditions such as asthma. Wildfire smoke is a mixture of hazardous air pollutants and airborne particulate matter and wildfires are burning larger areas of land and lasting longer, extending the smoke season. The wildfire season is also expected to lengthen as a result of the changing climate. This scoping review examines publications related to wildfires and health in order to explore the ways in which nursing science contributes to research on the health effects of wildfires and strategies to decrease exposure to wildfires and/or wildfire smoke. Nursing's contribution to wildfire research needs to increase to meet the demands of this rapidly growing, international problem. Nurses have an opportunity to protect the public's health through interventional research focused on preventing exposure and applying what is learned to practice.
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Cianconi P, Betrò S, Janiri L. The Impact of Climate Change on Mental Health: A Systematic Descriptive Review. Front Psychiatry 2020; 11:74. [PMID: 32210846 PMCID: PMC7068211 DOI: 10.3389/fpsyt.2020.00074] [Citation(s) in RCA: 256] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/28/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Climate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the entire scientific community. Rising temperatures, heat waves, floods, tornadoes, hurricanes, droughts, fires, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental. However, there is a clear lack in psychiatric studies on mental disorders linked to climate change. METHODS Literature available on PubMed, EMBASE, and Cochrane library until end of June 2019 were reviewed. The total number of articles and association reports was 445. From these, 163 were selected. We looked for the association between classical psychiatric disorders such as anxiety schizophrenia, mood disorder and depression, suicide, aggressive behaviors, despair for the loss of usual landscape, and phenomena related to climate change and extreme weather. Review of literature was then divided into specific areas: the course of change in mental health, temperature, water, air pollution, drought, as well as the exposure of certain groups and critical psychological adaptations. RESULTS Climate change has an impact on a large part of the population, in different geographical areas and with different types of threats to public health. However, the delay in studies on climate change and mental health consequences is an important aspect. Lack of literature is perhaps due to the complexity and novelty of this issue. It has been shown that climate change acts on mental health with different timing. The phenomenology of the effects of climate change differs greatly-some mental disorders are common and others more specific in relation to atypical climatic conditions. Moreover, climate change also affects different population groups who are directly exposed and more vulnerable in their geographical conditions, as well as a lack of access to resources, information, and protection. Perhaps it is also worth underlining that in some papers the connection between climatic events and mental disorders was described through the introduction of new terms, coined only recently: ecoanxiety, ecoguilt, ecopsychology, ecological grief, solastalgia, biospheric concern, etc. CONCLUSIONS The effects of climate change can be direct or indirect, short-term or long-term. Acute events can act through mechanisms similar to that of traumatic stress, leading to well-understood psychopathological patterns. In addition, the consequences of exposure to extreme or prolonged weather-related events can also be delayed, encompassing disorders such as posttraumatic stress, or even transmitted to later generations.
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Affiliation(s)
- Paolo Cianconi
- Department of Neurosciences, Institute of Psychiatry, Catholic University, Rome, Italy
| | | | - Luigi Janiri
- Department of Neurosciences, Institute of Psychiatry, Catholic University, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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13
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Gouweloos-Trines J, Te Brake H, Sijbrandij M, Boelen PA, Brewin CR, Kleber RJ. A longitudinal evaluation of active outreach after an aeroplane crash: screening for post-traumatic stress disorder and depression and assessment of self-reported treatment needs. Eur J Psychotraumatol 2019; 10:1554406. [PMID: 30693072 PMCID: PMC6338285 DOI: 10.1080/20008198.2018.1554406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/06/2018] [Accepted: 11/14/2018] [Indexed: 01/20/2023] Open
Abstract
Background: In 2009, an aeroplane crashed near Amsterdam. To remedy unmet mental health needs, active outreach was used to identify victims at risk for post-traumatic stress disorder (PTSD) and depression. Objective: The active outreach strategy was evaluated by examining the accuracy of screening methods in predicting PTSD and depression, self-reported treatment needs, and the extent to which perceived treatment needs predict trajectories of PTSD. Method: In 112 adult survivors, semi-structured telephone interviews were held at 2 (T1, n = 76), 9 (T2, n = 77) and 44 months (T3, n = 55) after the crash. The Trauma Screening Questionnaire (TSQ) and the Patient Health Questionnaire-2 (PHQ-2) measured symptoms of PTSD and depression, respectively. At T3, a clinical interview assessed PTSD and depression diagnoses. Based on the TSQ scores at the three time-points, participants were grouped into five 'trajectories': resilient (n = 38), chronic (n = 30), recovery (n = 9), delayed onset (n = 9) and relapse (n = 3). Results: The TSQ accurately predicted PTSD at T3 (sensitivity: .75-1.00; specificity: .79-.90). The PHQ-2 showed modest accuracy (sensitivity: .38-.89; specificity: .67-.90). Both measures provided low positive predictive values (TSQ: 0.57; PHQ-2: .50 at T3). A number of participants reported unmet treatment needs (T1: 32.9%; T2: 19.5%; T3: 10.9%). Reporting unmet needs at T2 was more often assigned to a chronic PTSD trajectory compared to reporting no needs (p < .01). Conclusions: The prevalence of unmet needs at 44 months after the crash within a chronic PTSD trajectory indicated that active outreach may be warranted. Nevertheless, although the TSQ was accurate, many participants screening positive did not develop PTSD. This implies that, although active outreach may benefit those with unmet needs, it also has its costs in terms of possible unnecessary clinical assessments.
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Affiliation(s)
- Juul Gouweloos-Trines
- Knowledge Center Impact, Arq Psychotrauma Expert Group, Diemen, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Hans Te Brake
- Knowledge Center Impact, Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Free University of Amsterdam, Amsterdam, The Netherlands
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rolf J Kleber
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
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14
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Cherry N, Haynes W. Effects of the Fort McMurray wildfires on the health of evacuated workers: follow-up of 2 cohorts. CMAJ Open 2017; 5:E638-E645. [PMID: 28819065 PMCID: PMC5621945 DOI: 10.9778/cmajo.20170047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated. METHODS People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire. RESULTS Of the 129 participants, 109 were in the Fort McMurray area on May 3. Thirty-seven (33.9%) of the participants who were in Fort McMurray on May 3 reported a health condition, including respiratory symptoms (n = 17) and mental ill health (n = 17), immediately after the fire. At follow-up, a mean of 102 days after the fire, 11 participants (10.1%) reported a fire-related health condition, including mental ill health (n = 8) and respiratory symptoms (n = 2). There was no difference before and after the fire in use of alcohol, cigarettes, recreational drugs or medication. One in 4 participants (32 [24.6%]) had not worked since the fire, and fewer than half (58 [44.6%]) had returned to Fort McMurray. Of the 90 participants evacuated, 15 (16.7%) had scores indicative of moderate or severe anxiety or depression on the Hospital Anxiety and Depression Scale. Those evacuated had significantly higher mean anxiety (p = 0.01) and depression (p = 0.04) scores than those not evacuated. Regression modelling showed that anxiety scores were higher for women, with longer time since the fire and with evacuation to a motel. Depression scores were higher for women and with financial loss because of lack of work. INTERPRETATION Although evacuation was associated with higher anxiety and depression scores, persisting ill health was not widespread at early follow-up after the fire. Although these results are encouraging, these "healthy worker" results cannot be generalized to all evacuees.
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Affiliation(s)
- Nicola Cherry
- Affiliation: Division of Preventive Medicine (Cherry, Haynes), University of Alberta, Edmonton, Alta
| | - Whitney Haynes
- Affiliation: Division of Preventive Medicine (Cherry, Haynes), University of Alberta, Edmonton, Alta
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Bassilios B, Nicholas A, Reifels L, King K, Spittal MJ, Fletcher J, Pirkis J. Improving access to primary mental health care for Australian children. Aust N Z J Psychiatry 2016; 50:1074-1084. [PMID: 27694639 DOI: 10.1177/0004867416671412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study examines the uptake by children aged predominantly 0-11 years of an Australian primary mental health service - the Access to Allied Psychological Services programme - which began in 2001. In particular, it considers access to, and use of, the child component of Access to Allied Psychological Services, the Child Mental Health Service, introduced in 2010. METHOD Using routinely collected programme data from a national minimum dataset and regional population data, we conducted descriptive and regression analysis to examine programme uptake, predictors of service reach and consumer- and treatment-based characteristics of service. RESULTS Between 2003 and 2013, 18,631 referrals for children were made and 75,178 sessions were scheduled via Access to Allied Psychological Services, over 50% of which were via the Child Mental Health Service in its first 3 years of operation. The rate of referrals for children to the Child Mental Health Service was associated with the rate of Access to Allied Psychological Services referrals for consumers aged 12+ years. CONCLUSIONS The Child Mental Health Service has increased services provided within the Access to Allied Psychological Services programme for children with emotional and behavioural issues and their families, and is potentially filling a service gap in the area of prevention and early intervention for children who have significant levels of need but are unable to access other mental health services. Our findings are policy-relevant for other developed countries with a similar primary mental health care system that are considering means of improving service access by children.
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Affiliation(s)
- Bridget Bassilios
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia .,School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Angela Nicholas
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Kylie King
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Justine Fletcher
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
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