Climate change worry and the association with future depression and anxiety: cross-national analysis of 11 European countries

ABSTRACT BACKGROUND Climate change is one of the biggest threats to global health and can affect people’s mental health directly and indirectly. This study focused on the implications of climate change worry for mental health. OBJECTIVE To determine the association between climate change worry and future risk of depression, anxiety and sleep disturbance across 11 European countries. METHODS The study included 5,155 participants in the European Social Survey-10 (2020-22), which assessed climate change worry and subsequent follow-up CROss-National Online Survey 2 (CRONOS-2) wave 4, which measured symptoms of depression and anxiety (2022). Overall relationships between climate change worry and risk of depression, anxiety and sleep disturbance were explored using logistic regression models adjusting for potential confounders, then stratified by country. FINDINGS Climate change worry was associated with increased risk of anxiety (OR: 1.38, 95% CI: 1.13-1.68), but not depression (OR: 1.10, 95% CI: 0.94-1.29) or sleep disturbance (OR: 1.08, 95% CI: 0.92-1.27), in pooled analyses across countries. When stratified by country, climate worry had differing associations with the outcomes, with the strongest relationships between climate worry and anxiety found in Slovenia and Italy. CONCLUSIONS Climate change worry may contribute to clinically significant anxiety in some countries, but less so for depression and sleep disturbance. CLINICAL IMPLICATIONS Strategies to cope with climate change anxiety are needed as it does not align with traditional mental health models. Further research is needed to design and evaluate interventions and policies to support mental health in the context of climate change. What is already known on this topic Climate anxiety is a growing concern as the implications of climate change become more evident. Few studies have assessed how climate worry is related to mental health problems and research in this area is limited by methodological concerns, such as non-representative samples and cross-sectional studies. What this study adds Levels of climate-related worry vary across Europe, with the highest levels observed in Portugal, Austria and Slovenia, and lowest in Sweden, Iceland and Italy. Overall, climate worry was associated with future risk of clinical levels of anxiety, but not depression or sleep problems. In stratified analyses, the strongest associations were found for anxiety in Slovenia and Italy. How this study might affect research, practice or policy The mental health implications of climate change should be considered in both health and climate policies. Further research is required to assess country and regional-level factors which may affect the relationship between climate worry and mental health and potential causal effects investigated.