Climate change anxiety among psychiatric outpatients: associations with psychiatric symptoms and experience with climate change and natural disasters.

BACKGROUND: Climate change anxiety (CCA) has emerged as a significant psychological response to the global climate crisis. While prior research focuses on general populations, evidence derived from psychiatric clinical samples remains scarce. This study aims to investigate CCA levels and their associations with psychiatric symptoms, resilience, and disaster-related experiences among psychiatric outpatients. METHODS: A cross-sectional survey was conducted on 528 psychiatric outpatients aged 18-64 years at a university hospital in South Korea. The participants completed the Korean version of the Climate Change Anxiety Scale, along with standardized measures of depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), somatic symptoms (Korean Version of Somatic Symptom Scale-8), and resilience (Brief Resilience Scale). CCA was analyzed as a continuous variable, and a high-CCA group was defined as participants in the top quartile. Group comparisons, correlation analyses, and hierarchical regression analyses were performed. RESULTS: The mean CCA score was 19.05 (standard deviation = 8.11), with 24.1% of the participants classified as exhibiting high levels of CCA; these elevated levels were significantly associated with greater depressive (r = 0.31), anxiety (r = 0.36), and somatic symptoms (r = 0.39) and lower resilience (r = -0.11). Patients with direct exposure to natural disasters reported significantly higher levels of CCA and greater psychiatric symptom severity, along with lower levels of resilience. In hierarchical regression analyses, somatic symptoms (β = 0.252, p < 0.001), anxiety (β = 0.194, p < 0.001), middle age (β = 0.194, p < 0.001), and cumulative disaster exposure (β = 0.133, p = 0.003) were significant factors associated with CCA, explaining 20.6% of variance. CONCLUSION: CCA among psychiatric outpatients is closely associated with broad emotional and somatic symptom burdens and decreased resilience. Instead of representing an isolated environmental concern, CCA may reflect underlying affective and physiological vulnerabilities exacerbated by cumulative exposure to climate-related stressors. These findings underscore the clinical relevance of climate-related distress and highlight the need for longitudinal studies and targeted interventions among vulnerable populations.