Cosh, S.M.Ryan, R.Fallander, K.Robinson, K.Tognela, J.Tully, P.J.Lykins, A.D.2025-01-072025-01-072024BMC Psychiatry, 2024; 24(1):833-1-833-191471-244X1471-244Xhttps://hdl.handle.net/2440/143535Background and objectives: The adverse impacts of climate change on mental health is a burgeoning area, although fndings are inconsistent. The emerging concept of eco-anxiety represents distress in relation to climate change and may be related to mental health. The aim of this study was to explore the relationship between ecoanxiety with validated mental health outcomes, specifcally psychological distress and symptoms of major afective disorders. Design: Systematic review. Methods: EBSCO, ProQuest, and Web of Science databases were searched to February 2024 for studies of adult samples quantifying eco-anxiety (exposure, i.e. fear, worry or anxiety in relation to climate change) and symptoms of psychological distress and major afective disorders (outcomes), as assessed by validated measures. Results: Full text review of 83 studies was performed, and k=35 studies were included in the review (N=45 667, 61% female, Mage 31.2 years). Consistently, eco-anxiety showed small to large positive correlations with mental health outcomes of psychological distress, depression symptoms, anxiety symptoms, and stress symptoms. However, results regarding post-traumatic stress disorder symptoms and pathological worry were mixed. Stronger associations were observed where eco-anxiety was operationalised as‘anxiety’ rather than‘worry’. Conclusions: Findings underscore that eco-anxiety is related to psychological burden. Greater consideration of ecoanxiety in assessment and treatment is needed in clinical practice and further policy development is warranted at the intersection of climate and health to address the mental health challenges posed by climate change.en© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modifed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.Eco-worry; Climate change distress; Eco-stress; Psychological disorders; Ecological worry; Wellbeing; Climate change anxiety; Mental health disordersHumansAnxietyMental HealthAdultFemaleMaleClimate ChangePsychological DistressJournal article10.1186/s12888-024-06274-1719404Cosh, S.M. [0000-0002-8003-3704]Tully, P.J. [0000-0003-2807-1313]