Mental health burden following extreme weather events in South-east Asia: A systematic review and meta-analysis

Abstract

Background: Exposure to extreme weatherly events potentially develops mental disorders among affected individuals.

Aim: To synthesize the burden of mental disorders following impact of extreme weather events in South-east Asian (SEA) countries.

Methods: Proposal was registered in PROSPERO register [CRD42023469788] and reported as per PRISMA-2020 guidelines. Studies reporting prevalence of mental health disorders following extreme weather events from SEA countries during 1990 and 2023 were searched on Embase, PubMed, and Scopus databases. Study quality was assessed using Appraisal tool for Cross-Sectional Studies. Overall pooled prevalence was computed using DerSimonian-Laird method for random-effects model and reported as 95% confidence intervals.

Results: On screening 12,046 records, we included 155 studies (2,04,474 participants) for analysis. Overall burden of mental disorders was 35.31% (95%CI: 30.42%-40.21%). In subgroup analysis, studies on cyclones, India, local residents, children and adolescents, rural settings, and community settings reported higher burden of mental disorders. Depression (28.58%; 95%CI: 24.05%-33.1%) and PTSD (29.36%; 95%CI: 26.26%-32.46%) had similar prevalence. Visiting tourists to SEA region experienced fear, fear of recurrence of tsunami, nightmares, and sense of helplessness. Mental health outcomes were relatively higher in studies conducted within 1 year of events. Heterogeneity and possibility of publication bias exists among the reported studies.

Conclusion: With the significant rise in episodes of extreme weather events in SEA region over the last three decades, mental disorders are documented in different proportions. We suggest prioritizing well-informed policies to formulate inclusive and resilient strategies on effectively identifying and treating mental health concerns among victims of extreme weather events.

Keywords: Cyclones; floods; mental health disorders; posttraumatic stress; south-east Asia; tsunami.

Figure 1

Flowchart of literature search and study selection according to the PRISMA standard

Figure 2

Forest plot showing pooled prevalence of burden of mental health, anxiety, fear, suicidal tendency, alcohol dependence and stress among the selected studies

Figure 3

Forest plot showing pooled prevalence of depressive disorders and PTSD among the selected studies