Climate change, climate-related disasters and mental disorders in low- and middle-income countries: a scoping review
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BMJ Open. 2021 Oct 14; 11 (10): e051908. doi: 10.1136 / bmjopen-2021-051908.
INTRODUCTION: Climate change and climate-related disasters negatively affect mental health. Low and Middle Income Countries (LMICs) are particularly vulnerable to the impacts of climate change and climate-related disasters and often lack adequate mental health infrastructure. We used the scoping methodology to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders in people living in LMICs. We also sought to recognize the existing gaps in this area of the literature.
METHODS: This review followed the Preferred Reporting Items checklist for systematic reviews and the Meta-Analyzes extension for scoping reviews. To identify relevant studies, we searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo, and Sociological Abstracts) from January 1, 2007 to December 31, 2019. We also searched the gray literature . The included studies had an adult-focused LMIC population, exposure to climate change or climate-related disaster, and a mental disorder outcome. Relevant information about the study was extracted and synthesized.
RESULTS: Fifty-eight studies were identified, most of which (n = 48) used a cross-sectional design. The most commonly studied exposure-outcome combinations were flood-related post-traumatic stress disorder (PTSD) (n = 28), flood-related depression (n = 15), and storm-related PTSD (n = 13) . The majority of studies have identified a positive association between exposure and outcomes. However, few studies included a reference or comparison group (i.e., unexposed), thus limiting our understanding of the magnitude or nature of this association. There was also great heterogeneity in this literature, making the studies difficult to pool or compare. Several research gaps were identified, including the lack of longitudinal studies and the non-uniformity of geographic coverage.
CONCLUSION: To our knowledge, this was the first scoping study to investigate the relationship between climate change and climate-related disaster exposures and mental disorder outcomes in LMICs. Our findings support the need for further research, but also highlight that mental health should be a priority in climate change policy considerations in LMICs.