Climate-related flooding and mental health vulnerability: Post-traumatic stress, psychological distress, and climate worry in a European flood-affected population

Background Climate-related flooding is increasing in frequency and intensity across Europe, representing a major environmental exposure with multidimensional health consequences. While physical impacts are well documented, less is known about the interaction between post-traumatic stress and climate-related psychological responses in affected populations. Objectives This pilot study examined post-traumatic stress symptoms, general psychological distress, and climate change worry in adults exposed to severe flooding in Northern Italy and explored demographic and psychological correlates of post-traumatic stress severity. Methods A cross-sectional online survey was conducted between March and August 2025 among flood-exposed residents (n = 30) and a geographically proximate control group (n = 44). Validated self-report instruments included the International Trauma Questionnaire (ITQ), the Depression Anxiety Stress Scales (DASS-21), and the Climate Change Worry Scale (CCWS). Between-group comparisons, time-since-exposure analyses, and exploratory multivariable regression models were performed. Results One-third-of exposed participants (33.3%) met ICD-11 criteria for PTSD/C-PTSD, whereas no cases were identified in controls. Exposed individuals reported higher post-traumatic stress severity, psychological stress, and climate worry. Temporal proximity to the event and current perceived stress were independently associated with PTSD severity, while climate worry, although elevated and correlated with trauma symptoms, did not independently predict severity in multivariable analyses. Conclusions Exposure to climate-related flooding was associated with a substantial mental health burden months after the event. The observed co-occurrence of acute trauma responses, perceived stress, and climate-related worry highlights the need to integrate psychosocial indicators into climate adaptation and disaster risk reduction frameworks. Although based on a specific regional event, these findings offer transferable insights for benchmarking mental health vulnerability and informing cross-context resilience planning in climate-exposed communities.