Journal Article Annotations
2021, 4th Quarter
Annotations by Mary Burke, MD
This is the first large, global study of young people’s psychological response to climate change. 10,000 young people aged 16-25 responded. Across multiple geographic and economic demographics, young people report feeling high levels of distress, and betrayal by their governments for failing to act. Climate anxiety is a practical, non-pathological response to reality. However, the pervasive experience of anxiety about the future can exacerbate other anxieties or increase vulnerability to mental illnesses. Youth in India and the Philippines reported the highest levels of distress, with 74% in both countries reporting that their worry impacted functioning and 35% and 49% respectively reporting they were extremely worried. Youth in the USA reported the least distress, with only 26% reporting impact on function, and 19% reporting extreme distress.
Strength and weaknesses:
This is the first large scale, global survey of this topic, although there are increasing reports in the literature of anxiety in youth related to climate change. The authors build on smaller scale studies they have done previously. They do not specifically address mental illness per se but, rather, negative feelings that correspond to feeling betrayed by those in power. The authors note that the most important remedial response is meaningful action by those in power. They also note that the emergence of mental illness needs to be considered and monitored. Their closing comments are, “As a research team, we were disturbed by the scale of emotional and psychological effects of climate change upon the children of the world, and the number who reported feeling hopeless and frightened about the future of humanity.”
All mental health clinicians who treat youth should be aware of the increasingly pervasive and intense background pessimism about the future in these generations. In addition, the disparities in youth experiences based on country and location (southern more than northern countries) remind us again that climate change exacerbates global inequities.
This is a massive, comprehensive review of toxic exposures due to electronic waste, now a global problem. The authors focus on harms to pregnant women and developing children in areas near recycling plants. However, these toxic, persistent chemicals are found in water, food, and air, and are carried globally by water currents, wind, and food. This review highlights chemicals which cause developmental/ neuropsychiatric harms, including lead and other heavy metals, polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs). It also demonstrates medical harms including immune responsiveness and oxidative stress.
Strengths and weaknesses
This is a large-scale, comprehensive review robustly supporting prior studies of harms caused by these toxins.
Consumers continue to purchase and discard electronic devices at unnecessarily high rates, and there are no truly safe recycling methods. Lead at any level impacts IQ and worsens aggression and attentional problems. PCBs and PBDEs lower T3 levels and have been implicated in developmental harms. These chemicals also cause hormonal disruptions and impact the health of pregnancies. Understanding the epidemiology of toxin-related illnesses is important for clinicians who work at the juxtaposition of medical and psychiatric illness. In addition, better awareness of the harms of e-waste may spur us to alter our own consumer behaviour, and that of our institutions.
Organophosphate (OP) chemicals have been widely studied. In particular, OP pesticides have been shown to inhibitacetylcholinesterase, with significant developmental impacts. This review focuses on OPs in plasticizers and other common consumer products. Maternal blood and breastmilk have been found to contain biologically meaningful levels of these chemicals, which can adversely impact fetuses and babies.
Strength and weaknesses:
This review covers a diverse array of studies of neurotoxicity of these pervasive chemicals, from human to laboratory, and from different geographical areas. The review provides detailed molecular mechanisms for those who are interested, and again highlights the role of toxic contaminants on healthy brain function and neurodevelopment.
C-L psychiatrists, and especially those in out-patient obstetrical settings, can help educate patients about ways to mitigate toxic exposures and promote developmental health. There is also a need for more psychiatric research on the relationship between toxic exposures and neurobehavioral disturbances. For patient handouts and education, see https://prhe.ucsf.edu/toxic-matters and https://prhe.ucsf.edu/info.