‘Solastalgia’ might help explain effects of climate change on mental health

It’s caused by environmental change and is linked to depression, anxiety, and PTSD

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Solastalgia’ might help explain the negative effects of climate change on mental health, suggests a review of the available research, published in the open access journal BMJ Mental Health.

Solastalgia is caused by changes to the home or surrounding environment and is associated with depression, anxiety, and post traumatic stress disorder (PTSD), the findings show.

A blend of the words ‘solace’ and ‘nostalgia’, the term solastalgia was first coined in 2003 to refer to the lack of solace and feelings of pain or sickness caused by changes in a person’s immediate or surrounding environment.

Several scales have since been developed and validated to measure solastalgia, but the extent to which it might contribute to the effects of climate change on mental health aren’t known.

To explore this further, the researchers scoured research databases for studies on solastalgia and mental health published between 2003 and 2024. Out of an initial haul of 80, 19 were eligible for inclusion in the review: 5 quantitative studies in the core search; 14 qualitative studies in the extended search.

The studies were carried out in Australia, Germany, Peru and the USA, and involved a total of 5000+ participants.

The study findings of the core search consistently showed positive associations between solastalgia and mental health problems, including depression, anxiety, PTSD and somatisation—physical symptoms caused or worsened by psychological distress. 

The extended search backed up these findings, with qualitative studies suggesting that solastalgia is a very useful concept to understand the emotional responses of people affected by environmental change, including pessimism and lowered resilience.

“These findings are in line with the literature on positive links between environmental distress more generally and mental ill health. Notably, solastalgia is one of several eco-emotions, such as eco-anxiety, eco-grief, or eco-shame/-guilt, which might be important in explaining mental health problems arising from ecological crises,” point out the researchers. 

The researchers note that the strength of the observed associations wasn’t as strong for responses to natural disasters as it was for those associated with ongoing environmental destruction.

“This suggests that solastalgia might either be more intense or salient in scenarios of ongoing environmental destruction as opposed to one-time events, or in scenarios which are clearly human-made and not attributable to any other causes (eg, the weather instead of climate change). This notion fits in well with long-standing evidence in trauma research, according to which interpersonal traumas are most likely to cause PTSD,” they explain.

One plausible explanation for the link between solastalgia and mental health problems lies in the theory of learned helplessness, which suggests that depressive symptoms stem from a perceived loss of control and resulting powerlessness,” they suggest. 

“Indeed, studies have shown that solastalgia often involves feelings of helplessness and resignation, as environmental changes typically lie beyond the affected individual’s control.” 

The researchers acknowledge that they were only able to draw on a limited number of published studies on solastalgia, added to which all the included studies were observational, making it impossible to establish cause.

Nevertheless, they conclude: “Solastalgia can be seen as a valuable concept for assessing the mental health risks among populations exposed to environmental change. While solastalgia is a rational response to environmental change, it appears correlated with worse mental health.”

Further research is needed to tease out exactly how it might affect mental health, say the researchers. “[This] is crucial to ensure that the world is adequately prepared to address the mental health consequences of the climate crisis,” they insist. 

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Journal

BMJ Mental Health

DOI

10.1136/bmjment-2025-301639 

Subject of Research

People

Article Publication Date

5-Aug-2025

 

Childhood verbal abuse shows similar impact to adult mental health as physical abuse

While often not immediately obvious, its effects may be no less damaging or protracted; Prevalence of verbal abuse has risen substantially while that of physical abuse has halved

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Experiencing childhood verbal abuse shows a similar impact to adult mental health as physical abuse, suggests a large intergenerational study, published in the open access journal BMJ Open.

While often not immediately obvious, the effects of verbal abuse may be no less damaging or protracted, the findings indicate. This large retrospective study of more than 20,000 participants examining birth cohorts from the 1950s onwards showed reductions in childhood physical abuse but increases in childhood verbal abuse.

Globally, an estimated 1 in 6 children endures physical abuse from family and caregivers. As well as the immediate physical trauma, physical abuse can exert lifelong effects on mental and physical health and wellbeing, note the researchers. 

This can manifest as higher levels of anxiety and depression, problematic alcohol and drug use, other ‘risky’ behaviours, violence towards others, and serious health issues, such as cardiovascular disease and diabetes, they explain.

Like physical abuse, verbal abuse is a source of toxic stress, which may affect the neurobiological development of children. It is thought that around one in three children around the globe is subjected to it, they add.

But despite its high prevalence, policies and initiatives to prevent violence against children have tended to focus on physical abuse, often overlooking the potential impact of verbal abuse, they point out.

To better glean the long-term effects on adult mental health of childhood physical and verbal abuse, separately and combined, the researchers pooled the data from 7 relevant studies, involving 20,687 adults from England and Wales, and published between 2012 and 2024.

The studies had all involved questions on childhood physical and verbal abuse using the validated Adverse Childhood Experiences (ACE) tool, and the short Warwick-Edinburgh Mental Wellbeing Scale to measure individual and combined components of adult mental wellbeing.

The survey asked participants how often over the past 2 weeks they had been: feeling optimistic about the future; feeling useful; feeling relaxed; dealing with problems well; thinking clearly; feeling close to other people; and able to make up their own mind about things.

Responses were scored from 1 (none of the time) to 5 (all of the time), and added up. Low mental wellbeing was considered as being more than one standard deviation below average scores (equivalent to around 1 in 6 of the sample).

Analysis of all the data showed that experience of either physical or verbal abuse as a child was independently associated with a similar significant increase (52% and 64%, respectively) in the likelihood of low mental wellbeing as an adult.

And experience of both abuse types more than doubled this likelihood compared with no exposure to either type. 

Even when physical abuse was part of a person’s childhood experiences, those who had also experienced verbal abuse as a child faced an additional risk, with the prevalence of low mental wellbeing rising from 16% with no abuse to 22.5% (physical abuse only), 24% (verbal abuse only) and 29% (both physical and verbal abuse). 

Individual components of mental wellbeing also showed similar associations, with the prevalence of never or rarely having felt close to people in the preceding fortnight rising from 8% for neither abuse type, to 10% for physical abuse alone, to just over 13.5% for verbal abuse alone, and to just over 18%  for both types, after adjusting for potentially influential factors. 

Those born in or after 2000 had higher likelihoods of all individual poor mental wellbeing components as well as overall low mental wellbeing. And men were more likely to report never or rarely feeling optimistic, useful, or close to other people, while women were more likely to report never or rarely feeling relaxed.

The prevalence of child physical abuse halved from around 20% among those born between 1950 and 1979 to 10% among those born in 2000 or later. But the reverse was true of the prevalence of verbal abuse, which rose from 12% among those born before 1950 to around 20% among those born in 2000 or later.

Reported physical and verbal abuse were both highest among those who lived in areas of greatest deprivation.

This is an observational study, and as such, can’t establish cause and effect. The researchers also acknowledge that the study relied on the retrospective recall and report of verbal and physical abuse, so inaccuracies may have crept in. 

Nor were they able to measure the severity of either type of abuse, the age at which it had occurred, or how long it had gone on for, all of which might be highly influential, they suggest.

But they nevertheless conclude: “Verbal abuse may not immediately manifest in ways that catch the attention of bystanders, clinicians, or others in supporting services with a responsibility for safeguarding children. However, as suggested here, some impacts may be no less harmful or protracted. 

“In an increasing range of countries, parents, caregivers, teachers, and others are in roles where legislation now prevents the physical abuse of children, regardless of whether the intent would previously have been considered abusive, punitive, or educational. This leaves a potential void which should be filled with instructional advice and support on appropriate parenting, discipline, and control of children.

“Without such support, and in an absence of public knowledge of the damages caused by child verbal abuse, measures to reduce the physical punishment of children risk simply swapping one type of harmful abuse for another, with equally long-term consequences.”

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Journal

BMJ Open

DOI

10.1136/bmjopen-2024-098412 

Method of Research

Observational study

Subject of Research

People

Article Title

Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales

Article Publication Date

5-Aug-2025

New term for systematic, deliberate attacks on healthcare as acts of war: ‘healthocide’

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The deliberate destruction of health services and systems as an act of war should be termed ‘healthocide’ and medical practitioners should call out and stand firm against this weaponisation of healthcare, insists a thought-provoking commentary published in the open access journal BMJ Global Health.

Silence implies complicity and approval, and undermines international humanitarian law as well as medical and professional ethics, say Dr Joelle Abi-Rached and colleagues of the American University of Beirut, Lebanon.

Although they refer to other conflicts in El Salvador, Ukraine, Sudan, and Syria, the authors focus primarily on the impact of armed conflict on healthcare in Lebanon and Gaza. 

Data from Lebanon’s Ministry of Public Health show that between 8 October 2023 and 27 January 2025, 217 healthcare workers were killed by the Israel Defense Forces; 177 ambulances were damaged; 68 attacks on hospitals were recorded; and 237 attacks on emergency medical services took place, they say.

Israel’s military operations in Gaza since October 7, 2023 have resulted in at least 986 medical workers’ deaths: 165 doctors; 260 nurses; 184 health associates; 76 pharmacists; 300 management and support staff; and 85 civil defence workers, they add.  

“Both in Gaza and Lebanon, healthcare facilities have not only been directly targeted, but access to care has also been obstructed, including incidents where ambulances have been prevented from reaching the injured, or deliberately attacked,” note the authors. 

“What is becoming clear is that healthcare workers and facilities are no longer afforded the protection guaranteed by international humanitarian law,” they add.

Yet faced with such wanton destruction, doctors have done little, the authors suggest.

“These attacks have been met with astounding silence or, at best, terse and often belated statements from American, European, or Israeli medical associations, professional groups, and journals,” they point out.

“Are medical doctors ready to forsake the principle of medical neutrality, first forged amidst the carnage of 19th century wars and profoundly reshaped following the liberation of Nazi death camps in 1945? And if so, at what cost?” they ask.

“As difficult as this question is, it is one that physicians must address as they grapple with the normalisation of healthcare’s weaponisation in a world where warfare has changed dramatically, marked by the use of Artificial Intelligence for mass killing, the reliance on drones and killing robots, the deployment of internationally banned weapons, which carry devastating public health and ecological consequences, and, of course, the looming threat of nuclear weapons,” they write.

The ‘normalisation’ of healthcare attacks has increased alarmingly over the past few years, say the authors. “But what we are witnessing today is more pernicious than mere normalisation of such attacks, something that could be described as ‘healthocide’: the deliberate killing and/or destruction of health services and systems for ideological purposes.”

Normalising or excusing healthocide sets a dangerous precedent, the authors argue, as it emboldens future violators and erodes the principle of medical neutrality, which is essential for ensuring impartial and humane care during conflict.

“Medical neutrality is not ‘apolitical’; for us it means standing with humanity, social justice, and health-enabling policies, they add.

The actions medical practitioners must take include advocating for enforcement of justice and international humanitarian law; and documenting and exposing abuses to medical neutrality by both state and non-state actors, insist the authors.

“Rather than passively observe the erosion and normalisation of the weaponisation of health and healthcare, [we call] for critical reflection and decisive action, underscoring that silence implies complicity, approval, or the toleration of double-standards — all of which stand in clear opposition to international humanitarian law and medical deontology [ethics],” they conclude.

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Journal

BMJ Global Health

DOI

10.1136/bmjgh-2024-018656 

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

Healthocide and medical neutrality: a call for action and reflection

Article Publication Date

5-Aug-2025

Disclaimer: AAAS and E

 

The Lancet Rheumatology: Course of psychotherapy for low back pain remains effective for at least three years, finds trial

The Lancet

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A type of psychotherapy called cognitive functional therapy (CFT) [1] is the first treatment for chronic disabling low back pain with good evidence that it can effectively reduce disability due to the pain for more than a year, finds a randomised controlled trial (RCT) published in The Lancet Rheumatology journal.

Low back pain is a long-term health condition for many people marked by unpredictable recurrences or pain flare ups. Interventions for low back pain have previously typically produced only small and short-term effects. A previous study published in The Lancet [2] found CFT was more effective than usual care [3] at improving self-reported physical activity participation in those with low back pain up to one year; the current trial is the first to show that these effects are sustained up to three years. 
 
The RESTORE RCT included 492 patients with chronic low back pain in Australia, who were randomly assigned to receive eight treatment sessions of usual care, CFT, or CFT plus biofeedback (a technique using sensors to measure body functions such as heart rate and enable the patient to modify them). While those who received CFT and CFT plus biofeedback saw improvements in their physical activity participation over usual care, the difference between those receiving CFT-only and CFT plus biofeedback at three years were small and not significant, which is also consistent with the 3-month and 1-year results. 
 
The authors say that the current trial demonstrates that CFT has long-term benefits on physical activity of those with low back pain and provides an opportunity to markedly reduce its impact if the intervention can be widely implemented. The authors highlight that implementation of CFT requires scaling up of clinician training to increase accessibility, and replication studies in diverse healthcare systems.

[1] CFT helps the patient change their mindset about the pain and self-manage via movement pattern changes and lifestyle changes. 
[2] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext 
[3] Usual care was any treatment the health provider recommended or the patient chose. It may have included painkillers, physical therapy and/or massage therapy. 

The Lancet Rheumatology: Course of psychotherapy for low back pain remains effective for at least three years, finds trial

A type of psychotherapy called cognitive functional therapy (CFT) [1] is the first treatment for chronic disabling low back pain with good evidence that it can effectively reduce disability due to the pain for more than a year, finds a randomised controlled trial (RCT) published in The Lancet Rheumatology journal.

Low back pain is a long-term health condition for many people marked by unpredictable recurrences or pain flare ups. Interventions for low back pain have previously typically produced only small and short-term effects. A previous study published in The Lancet [2] found CFT was more effective than usual care [3] at improving self-reported physical activity participation in those with low back pain up to one year; the current trial is the first to show that these effects are sustained up to three years. 
 
The RESTORE RCT included 492 patients with chronic low back pain in Australia, who were randomly assigned to receive eight treatment sessions of usual care, CFT, or CFT plus biofeedback (a technique using sensors to measure body functions such as heart rate and enable the patient to modify them). While those who received CFT and CFT plus biofeedback saw improvements in their physical activity participation over usual care, the difference between those receiving CFT-only and CFT plus biofeedback at three years were small and not significant, which is also consistent with the 3-month and 1-year results. 
 
The authors say that the current trial demonstrates that CFT has long-term benefits on physical activity of those with low back pain and provides an opportunity to markedly reduce its impact if the intervention can be widely implemented. The authors highlight that implementation of CFT requires scaling up of clinician training to increase accessibility, and replication studies in diverse healthcare systems.

[1] CFT helps the patient change their mindset about the pain and self-manage via movement pattern changes and lifestyle changes. 
[2] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext 
[3] Usual care was any treatment the health provider recommended or the patient chose. It may have included painkillers, physical therapy and/or massage therapy. 

 

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Journal

The Lancet Rheumatology

DOI

10.1016/S2665-9913(25)00135-3/fulltext 

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Title

Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): 3-year follow-up of a randomised, controlled trial

Article Publication Date

5-Aug-2025

COI Statement

See paper

Sustained benefits from mind and body treatment for back pain in RESTORE trial three-year follow-up

A personalised program of cognitive functional therapy (CFT) for chronic disabling low back pain produced clinically significant improvements in pain-related activity and pain intensity compared to usual care

Macquarie University

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Australian research has shown that a personalised program that helps people with chronic, disabling low back pain better understand their condition and take charge of its management produces large benefits that are sustained over three years.

In the RESTORE trial, conducted at centres in Sydney and Perth, a seven-session program of cognitive functional therapy (CFT) delivered by specially trained physiotherapists significantly reduced people’s back pain and improved their function, compared with usual care.

Data just published in medical journal The Lancet Rheumatology show these improvements were largely maintained over three years of follow-up.

The persistent effect of CFT over time is a new and very important finding, says lead author Professor Mark Hancock, Professor of Physiotherapy at Macquarie University.

“This the first large, high-quality study investigating the long-term impact of CFT, and shows that it’s effective and remains effective,” says Professor Hancock.

“In fact, our previous systematic review shows there are relatively few long-term outcome studies of other treatments for chronic low back pain.”

Around 4 million Australians – one in six – live with back problems, making them the third leading cause of disease burden overall, according to the Australian Institute of Health and Welfare.

The development of CFT and its use in the RESTORE trial stemmed from what the researchers and clinicians describe as a “biopsychosocial” model of treatment, which targets the physical, psychological and social factors involved in chronic back pain and the disability it causes.

“An episode of back pain can understandably cause anxiety and fear, leading people to overprotect their body and avoid usual movements,” says study co-author Professor Peter O’Sullivan, John Curtin Distinguished Professor in the School of Allied Health Sciences at Curtin University.

“When this persists, it can set up a vicious cycle of pain sensitivity and limitation of activities,” he explains.

“CFT is about putting people in the driver’s seat: giving them the skills to manage their pain, and building their confidence to move, get active and back to living.”

Back pain is the number one cause of disability globally, says Professor Hancock, and is so common and disruptive that an intervention producing lasting reductions in pain and dysfunction offers potential for a major human and economic impact.

In Australia, an estimated $3.4 billion was spent treating and managing back problems, representing 2.2% of total health system expenditure in 2020-21.

“Things like massage, manipulation and medication can provide short-term symptom control but in the longer term, mind and body approaches that give patients the skills and confidence to self- manage, are much more effective,” says Professor Hancock.

“Our findings suggest the massive burden of low back pain could be markedly reduced if health policies supported widespread implementation of high-value, low-risk and sustained interventions like CFT, instead of less effective, short-term and potentially harmful interventions like opioids or surgery.”

The RESTORE study was led by researchers from Curtin University and Macquarie University, in partnership with Monash University, the University of Limerick, Imperial College London, the University of Southern Denmark, and the University of Western Australia. It was funded by the National Health and Medical Research Council and Curtin University.

Professor Mark Hancock is a Professor of Physiotherapy in the Macquarie University Faculty of Medicine, Health and Human Science.

Professor Peter O’Sullivan is a John Curtin Distinguished Professor in the School of Allied Health Sciences at Curtin University.

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Journal

The Lancet

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Title

Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): 3-year follow-up of a randomised, controlled trial

Article Publication Date

5-Aug-2025

 

Global network taps tree rings to study impact of tropical drought

University of Arizona

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A new study leveraging 20,000 tree-ring records and nearly 150 scientists' contributions from across the globe shows that, while droughts appear to have had a modest impact on tropical tree growth in the past, that may not be the case for long. 

The research team calculated that, on average across the tropics, trees grew 2.5 percent less during drought years compared to years with normal or above-average precipitation. Surprisingly, the researchers also found an almost complete recovery in the year following the drought. However, that resilience, they warn, could weaken when droughts occur more frequently and become more intense – particularly within drier, semi-arid regions of the tropics.

Few comprehensive studies on tropical tree rings have been published, largely because year-long warm and moist conditions were thought to prevent regular annual ring formation. But scientists have come to understand that some tropical tree species and their rings can chart water availability, explained Valerie Trouet, co-author on the study and professor of dendrochronology at the University of Arizona's Laboratory of Tree-Ring Research.

"Tropical dendrochronology has long been deemed impossible or at least too complex to use for synthesis science," said Trouet. "In this paper, we use the largest network of tropical tree-ring chronologies yet, to do exactly that, to synthesize the impact of drought on woody tree growth in tropical forests."

"Until now, we didn't know to what extent stem growth in tropical forests decreases during droughts," said Pieter Zuidema, lead author on the paper and professor at the Netherland's Wageningen University & Research. "With our new network of tree-ring records, we were able to calculate the effect of droughts on stem growth across the tropics for the first time."

Clogging the carbon sink

Tropical forests and woodlands are key components of the global carbon cycle, specifically in their role in sequestering CO2 – often for decades. During drought, tree growth usually slows, which reduces the amount of carbon stored. 

To understand and predict the risks that droughts pose for the long-term capture of carbon in tropical vegetation, the researchers used the largest collection of tropical tree-ring data to date: more than 20,000 tree-ring series from nearly 500 locations in 36 countries. 

The tree-ring data were collected at 483 locations spread across the tropics – from wet and warm Amazonian forests to dry forests in southern Africa and cooler Asian mountain forests. 

The researchers determined the driest years since 1930 for all locations, then calculated how much narrower the tree rings were during those years compared to normal years. They also measured the width of tree rings in the two years following a drought. 

Focusing their analysis on the top 10 percent of driest years, the research team observed stem growth of tropical trees decreased on average by 2.5 percent. For the top 5 percent of extreme years, that global average of growth decreased even further, down to 3.2 percent, explained Flurin Babst, a co-author on the study who helped design and run the analysis and an assistant professor in the U of A School of Natural Resources and the Environment. 

"An average growth reduction of 3.2 percent under drought may seem small," said Babst. "But given the dominant role that tropical forests and woodlands play in the global carbon cycle, the impacts of intensifying drought on the land carbon sink could be substantial. This is relevant for the many initiatives worldwide that use tropical trees as carbon reservoirs to offset anthropogenic CO2 emissions."

In drier, semi-arid tropical regions, the average tree growth slowed down even further, by roughly 10 percent in a quarter of the locations included in the study. 

"This happened mainly in hot and dry regions, such as in northeastern Brazil and southern Africa," Zuidema said. "The effects of droughts can be more extreme there because trees shed their leaves quickly and the soil retains less moisture. In wetter areas, such as Amazonian forests, the effects were weaker." 

The researchers warn that stem growth resilience could weaken when droughts occur more frequently and become more intense – something they have witnessed within the past few decades in research locations within the study. 

"Recent droughts have already caused stronger reductions in stem growth compared to earlier droughts. It gets harder for trees to recover," Zuidema said. "We expect that ongoing climate change will only exacerbate this effect."

Reduced tree growth has widely been associated with higher tree mortality, and while this study did not directly quantify tree mortality at the 483 tree-ring locations, the team used existing research to estimate that drought increased the normal tropical tree mortality rate by 0.1 percent. 

"Again, 0.1 percent is not a huge number," said Babst. "But considering the vast area that tropical forests and woodlands occupy, this increase in tree mortality leads to a notable amount of biomass that dies, decays, and releases CO2 back into the atmosphere. More research is clearly needed to better quantify this feedback."

A tropical tree-ring network

The study is the result of a recently formed network of tropical tree-ring studies, which aims to unite data from tree-ring studies across the tropics to better understand how tropical trees respond to current and future climatic conditions.

"Hundreds of tree-ring studies have been conducted on tropical trees over the past few decades," said Peter Groenendijk, co-author on the study and an assistant professor at University of Campinas in Brazil. "However, this is the first time those data have been compiled for large-scale analysis. We are trying to understand the past in order to predict the future."

Zuidema, Groenendijk, Trouet and Babst are the initial founders of the network and continue to serve as the core members responsible for its overall management. Today, the initiative has grown to include over 170 collaborators, contributing nearly 500 ring-width chronologies from more than 30 countries across all tropical continents, representing over 139 tree species. 

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Journal

Science

DOI

10.1126/science.adq6607 

Article Title

Pantropical tree rings show small effects of drought on stem growth