Fergusson, D. M., Boden, J. M. & Horwood, L. J. Recurrence of major depression in adolescence and early adulthood, and later mental health, educational and economic outcomes. Br. J. Psychiatry 191, 335–342 (2007).
Committee on Psychosocial Aspects of Child Family Health et al. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics 129, e224–e231 (2012).
Kieling, C. et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study. JAMA Psychiatry 81, 347–356 (2024).
Thapar, A., Eyre, O., Patel, V. & Brent, D. Depression in young people. Lancet 400, 617–631 (2022).
Gili, M. et al. Mental disorders as risk factors for suicidal behavior in young people: a meta-analysis and systematic review of longitudinal studies. J. Affect. Disord. 245, 152–162 (2019).
Viner, R. M. et al. Adolescence and the social determinants of health. Lancet 379, 1641–1652 (2012).
NOAA National Centers for Environmental Information. Annual 2022 Global Climate Report. https://www.ncei.noaa.gov/access/monitoring/monthly-report/global/202307 (2023).
Obradovich, N., Migliorini, R., Paulus, M. P. & Rahwan, I. Empirical evidence of mental health risks posed by climate change. Proc. Natl. Acad. Sci. USA 115, 10953–10958 (2018).
Mitchell, A., Maheen, H. & Bowen, K. Mental health impacts from repeated climate disasters: an Australian longitudinal analysis. Lancet Reg. Health West. Pac. 47 (2024).
Watts, N. et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet 391, 581–630 (2018).
UNICEF. A threat to progress: confronting the effects of climate change on child health and well-being. https://www.unicef.org/media/159341/file/A_Threat_to_Progress_190824%20EN.pdf (2024).
UNICEF. Almost half a billion children live in areas experiencing at least twice as many extremely hot days as their grandparents, https://www.unicef.org/press-releases/almost-half-billion-children-live-areas-experiencing-least-twice-many-extremely-hot (2024).
O’Neill, M. S. & Ebi, K. L. Temperature Extremes and Health: Impacts of Climate Variability and Change in the United States. J. Occupat. Environ. Med. 51, 13–25 (2009).
Martin, G., Reilly, K., Everitt, H. & Gilliland, J. A. Review: the impact of climate change awareness on children’s mental well-being and negative emotions—a scoping review. Child Adolesc. Ment. Health 27, 59–72 (2022).
Albrecht, G. et al. Solastalgia: the distress caused by environmental change. Australas. Psychiatry 15, S95–S98 (2007).
Palinkas, L. A. & Wong, M. Global climate change and mental health. Curr. Opin. Psychol. 32, 12–16 (2020).
Kovats, R. S. & Hajat, S. Heat stress and public health: a critical review. Annu. Rev. Public Health 29, 41–55 (2008).
Pfautsch, S., Wujeska-Klause, A. & Walters, J. Outdoor playgrounds and climate change: Importance of surface materials and shade to extend play time and prevent burn injuries. Build. Environ. 223, 109500 (2022).
Mullins, J. T. & White, C. Temperature and mental health: evidence from the spectrum of mental health outcomes. J. Health Econ. 68, 102240 (2019).
Yablonskiy, D. A., Ackerman, J. J. H. & Raichle, M. E. Coupling between changes in human brain temperature and oxidative metabolism during prolonged visual stimulation. Proc. Natl. Acad. Sci. USA 97, 7603–7608 (2000).
McMorris, T. et al. Heat stress, plasma concentrations of adrenaline, noradrenaline, 5-hydroxytryptamine and cortisol, mood state and cognitive performance. Int. J. Psychophysiol. 61, 204–215 (2006).
Thompson, R. et al. Ambient temperature and mental health: a systematic review and meta-analysis. Lancet Planet. Health 7, e580–e589 (2023).
Liu, J. et al. Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. Environ. Int. 153, 106533 (2021).
Morgan, R. L. et al. GRADE: Assessing the quality of evidence in environmental and occupational health. Environ. Int. 92-93, 611–616 (2016).
Page, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372, n71 (2021).
Sawyer, S. M., Azzopardi, P. S., Wickremarathne, D. & Patton, G. C. The age of adolescence. Lancet Child Adolesc. Health 2, 223–228 (2018).
Hwong, A. R. et al. Climate change and mental health research methods, gaps, and priorities: a scoping review. Lancet Planet. Health 6, e281–e291 (2022).
National Toxicology Program US Department of Health and Human Services National Institutes of Health. OHAT Risk of Bias Rating Tool for Human and Animal Studies. https://ntp.niehs.nih.gov/sites/default/files/ntp/ohat/pubs/riskofbiastool_508.pdf (2015).
Guyatt, G. H. et al. What is “quality of evidence” and why is it important to clinicians?. BMJ 336, 995 (2008).
Rooney, A. A., Boyles, A. L., Wolfe, M. S., Bucher, J. R. & Thayer, K. A. Systematic review and evidence integration for literature-based environmental health science assessments. Environ. Health Perspect. 122, 711–718 (2014).
IntHout, J., Ioannidis, J. P. A. & Borm, G. F. The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method. BMC Med. Res. Methodol. 14, 25 (2014).
World Health Organization. Adolescent health: Overview, https://www.who.int/health-topics/adolescent-health#tab=tab_1 (2025).
Borenstein, M. Avoiding common mistakes in meta-analysis: Understanding the distinct roles of Q, I-squared, tau-squared, and the prediction interval in reporting heterogeneity. Res. Synth. Methods 15, 354–368 (2024).
Higgins, J. P. T., Thompson, S. G., Deeks, J. J. & Altman, D. G. Measuring inconsistency in meta-analyses. BMJ 327, 557 (2003).
Egger, M., Smith, G. D., Schneider, M. & Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629 (1997).
Sedgwick, P. Meta-analyses: how to read a funnel plot. Br. Med. J. 346, f1342 (2013).
Stata Statistical Software: Release 17 (Stata Corp. 2021).
Basu, R., Gavin, L., Pearson, D., Ebisu, K. & Malig, B. Examining the association between apparent temperature and mental health-related emergency room visits in California. Am. J. Epidemiol. 187, 726–735 (2018).
Villeneuve, P. J. et al. Daily changes in ambient air pollution concentrations and temperature and suicide mortality in Canada: Findings from a national time-stratified case-crossover study. Environ. Res. 223, 115477 (2023).
Bernstein, A. aron et al. Warm season and emergency department visits to U.S. Children’s Hospitals. Environ. Health Perspect. 130, 017001 (2022).
Chan, E. Y. Y. et al. Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region. Int. J. Environ. Res. Public Health 15, 754 (2018).
da Silva, I., de Almeida, D. S., Hashimoto, E. M. & Martins, L. D. Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil. Environ. Health 19, 79 (2020).
Isaksen, T. B. et al. Increased mortality associated with extreme-heat exposure in King County, Washington, 1980–2010. Int. J. Biometeorol. 60, 85–98 (2016).
Niu, Y. et al. Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: a time-series study. Sci. Total Environ. 733, 139040 (2020).
Parks, R. M. et al. Anomalously warm temperatures are associated with increased injury deaths. Nat. Med. 26, 65–70 (2020).
Zhou, Y. et al. The role of extreme high humidex in depression in chongqing, China: a time series-analysis. Environ. Res. 222, 115400 (2023).
Wang, S. et al. Effect of increasing temperature on daily hospital admissions for schizophrenia in Hefei, China: a time-series analysis. Public Health 159, 70–77 (2018).
Zhou, Q. et al. Immediate and delayed effects of environmental temperature on schizophrenia admissions in Liuzhou, China, 2013–2020: a time series analysis. Int. J. Biometeorol. 68, 843–854 (2024).
Trang, P. M., Rocklöv, J., Giang, K. B., Kullgren, G. & Nilsson, M. Heatwaves and hospital admissions for mental disorders in Northern Vietnam. PLoS One 11, e0155609 (2016).
Nitschke, M., Tucker, G. R. & Bi, P. Morbidity and mortality during heatwaves in metropolitan Adelaide. Med. J. Aust. 187, 662–665 (2007).
Kim, Y. et al. Suicide and ambient temperature in East Asian countries: a time-stratified case-crossover analysis. Environ. Health Perspect. 124, 75–80 (2016).
Niu, L. et al. Temperature and mental health–related emergency department and hospital encounters among children, adolescents and young adults. Epidemiol. Psychiatr. Sci. 32, e22 (2023).
Rahman, M. M. et al. Ambient temperature and air pollution associations with suicide and homicide mortality in California: A statewide case-crossover study. Sci. Total Environ. 874, 162462 (2023).
Zhang, S. et al. The effect of temperature on cause-specific mental disorders in three subtropical cities: a case-crossover study in China. Environ. Int. 143, 105938 (2020).
Cohen, G. et al. Daily temperature variability and mental health-related hospital visits in New York State. Environ. Res. 257, 119238 (2024).
He, W.-Q. et al. Extreme heat stress and unplanned hospital admissions. Pediatrics 155, e2024068183 (2024).
Ndovu, A. et al. Spatial variation in the association between extreme heat events and warm season pediatric acute care utilization: a small-area assessment of multiple health conditions and environmental justice implications in California (2005–2019). Environ. Health Perspect. 133, 017010 (2025).
Zhong, Z. et al. The impact of different types of extreme temperature events on mental disorders: a case-crossover study in Anhui Province, China. Environ. Res. 277, 121526 (2025).
Stowell, J. D. et al. Warm-season temperatures and emergency department visits among children with health insurance. Environ. Res. Health 1, 015002 (2023).
Komulainen, K. et al. Climatic exposures in childhood and the risk of schizophrenia from childhood to early adulthood. Schizophr. Res. 248, 233–239 (2022).
Xu, Y., Wheeler, S. A. & Zuo, A. Will boys’ mental health fare worse under a hotter climate in Australia?. Popul. Environ. 40, 158–181 (2018).
Hu, J. et al. Associations of exposure to heatwaves with depression and anxiety among adolescents: a cross-sectional study of the Chinese adolescent health survey. J. Affect. Disord. 387, 119499 (2025).
Runkle, J. D. et al. Assessing the impact of heatwaves on emergency visits for major depression and suicidal ideation in youth with attention-deficit/hyperactivity disorder. PLOS Ment. Health 2, e0000444 (2025).
Florido Ngu, F., Kelman, I., Chambers, J. & Ayeb-Karlsson, S. Correlating heatwaves and relative humidity with suicide (fatal intentional self-harm). Sci. Rep. 11, 22175 (2021).
Rother, H.-A. et al. Impact of extreme weather events on Sub-Saharan African child and adolescent mental health: the implications of a systematic review of sparse research findings. J. Clim. Change Health 5, 100087 (2022).
Uibel, D., Sharma, R., Piontkowski, D., Sheffield, P. E. & Clougherty, J. E. Association of ambient extreme heat with pediatric morbidity: a scoping review. Int. J. Biometeorol. 66, 1683–1698 (2022).
Fung, K. Y., Krewski, D., Chen, Y., Burnett, R. & Cakmak, S. Comparison of time series and case-crossover analyses of air pollution and hospital admission data. Int. J. Epidemiol. 32, 1064–1070 (2003).
Bhaskaran, K., Gasparrini, A., Hajat, S., Smeeth, L. & Armstrong, B. Time series regression studies in environmental epidemiology. Int. J. Epidemiol. 42, 1187–1195 (2013).
Maclure, M. & Mittleman, M. A. Should we use a case-crossover design?. Annu. Rev. Public Health 21, 193–221 (2000).
Haines, A. et al. Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers. Lancet 374, 2104–2114 (2009).
Reed, A., Henning, B., Cortes Espinosa, M., McKinley, H. & Busch Isaksen, T. Building community resilience to extreme heat: Lessons learned from Spokane, WA community conversations. Environ. Res. Health 2, 045007 (2024).
Johar, H. et al. Community-based heat adaptation interventions for improving heat literacy, behaviours, and health outcomes: a systematic review. Lancet Planet. Health 9, 101207 (2025).
Ahdoot, S. et al. Climate change and children’s health: building a healthy future for every child. Pediatrics 153, e2023065504 (2024).
Hyndman, B. & Zundans-Fraser, L. Determining public perceptions of a proposed national heat protection policy for Australian schools. Health Promotion J. Aust. 32, 75–83 (2021).
Bitsko, R. H. Mental health surveillance among children—United States, 2013–2019. MMWR Suppl. 71, 1–42 (2022).
Marrast, L., Himmelstein, D. U. & Woolhandler, S. Racial and ethnic disparities in mental health care for children and young adults: a national study. Int. J. Health Serv. 46, 810–824 (2016).
Reiss, F. Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Soc. Sci. Med. 90, 24–31 (2013).
Bathiany, S., Dakos, V., Scheffer, M. & Lenton, T. M. Climate models predict increasing temperature variability in poor countries. Sci. Adv. 4, eaar5809 (2018).
Benz, S. A. & Burney, J. A. Widespread race and class disparities in surface urban heat extremes across the United States. Earth’s. Future 9, e2021EF002016 (2021).
Gronlund, C. J. Racial and socioeconomic disparities in heat-related health effects and their mechanisms: a review. Curr. Epidemiol. Rep. 1, 165–173 (2014).
Rakesh, A. et al. Extreme heat: a global call to action. Bull. World Health Organ. 103, 466 (2025).