Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
BMJ Open. 2021 Oct 14;11(10):e051908. doi: 10.1136/bmjopen-2021-051908.
Climate change and climate-related disasters adversely 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 healthcare infrastructure. We used the scoping review methodology to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among those living in LMICs. We also aimed to recognise existing gaps in this area of literature.
This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. To identify relevant studies, we searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo and Sociological Abstracts) from 1 January 2007 to 31 December 2019. We also searched the grey literature. Included studies had an adult-focused LMIC population, a climate change or climate-related disaster exposure and a mental disorder outcome. Relevant study information was extracted and synthesised.
Fifty-eight studies were identified, most of which (n=48) employed 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 identified a positive exposure-outcome association. However, few studies included a baseline or comparator (ie, unexposed) group, thereby limiting our understanding of the magnitude or nature of this association. There was also great heterogeneity in this literature, making studies difficult to pool or compare. Several research gaps were identified including the lack of longitudinal studies and non-uniformity of geographic coverage.
To our knowledge, this was the first scoping review 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 within LMIC climate change policy considerations.
气候变化和与气候相关的灾害对心理健康有不利影响。中低收入国家（LMICs）特别容易受到气候变化和与气候相关的灾害的影响，而且往往缺乏足够的精神卫生保健基础设施。我们使用范围综述方法来确定暴露于气候变化和与气候相关的灾害如何影响生活在 LMICs 的人出现精神障碍。我们还旨在认识到这一文献领域的现有差距。
本综述遵循了用于范围综述的系统评价和元分析扩展的首选报告项目清单。为了确定相关研究，我们从 2007 年 1 月 1 日至 2019 年 12 月 31 日在五个电子数据库（MEDLINE、EMBASE、全球健康、APA PsycInfo 和社会学摘要）中进行了搜索。我们还搜索了灰色文献。纳入的研究有以成年人为主的 LMIC 人群、气候变化或与气候相关的灾害暴露和精神障碍结果。提取并综合了相关研究信息。
确定了 58 项研究，其中大多数（n=48）采用了横断面设计。最常研究的暴露-结果组合是与洪水有关的创伤后应激障碍（PTSD）（n=28）、与洪水有关的抑郁（n=15）和与风暴有关的 PTSD（n=13）。大多数研究都确定了积极的暴露-结果关联。然而，很少有研究包括基线或对照组（即未暴露组），从而限制了我们对这种关联的程度或性质的理解。这方面的文献也存在很大的异质性，使得研究难以合并或比较。确定了几个研究差距，包括缺乏纵向研究和地理覆盖范围的不一致性。
据我们所知，这是第一项调查中低收入国家气候变化和与气候相关的灾害暴露与精神障碍结果之间关系的范围综述。我们的研究结果支持进一步研究的必要性，但也强调在中低收入国家气候变化政策考虑中，精神健康应该是一个优先事项。
