Systematic Review of the Links between Eco-Distress and Mental Health

Eco-distress shows positive correlations with mental health impairments. However, the correlations reported by different studies vary widely. The aim of our review was to explore possible methodological sources for this heterogeneity, hereby deepening our understanding of eco-distress and its relationship with mental health.

Following PRISMA guidelines, Academic Search Complete, PubMed, PsycInfo, and Web of Science were searched on 15.03.2025 for publications reporting the initial development of instruments assessing eco-distress, subsequent validation studies, or correlations with mental health impairments. We analyzed the relationship of psychometric quality and the range of effect sizes descriptively, as well as the potential influence of the type of mental health questionnaire, the psychometric quality, and study and sample characteristics statistically as moderators in meta-analysis.

We included 87 studies reporting on 15 different instruments. The underlying definitions of eco-distress differed and psychometric quality was mixed. However, confidence intervals did not vary systematically due to psychometric quality. Overall, eco-distress and mental health impairments correlated with r = 0.32, 95% CI [0.27; 0.37]. Only type of mental health questionnaire moderated the effect size.

Although it varied in magnitude, there was a significant positive correlation between eco-distress and mental health impairments. However, type of eco-distress questionnaire did not systematically influence the effect size. The heterogeneity was considerable and could only be partially explained by the moderators used. Future research should focus on the psychometric evaluation of existing instruments, as information on psychometric quality was incomplete for many instruments.