Climate-related psychological distress among reproductive-age women: A qualitative content analysis

Introduction Climate change can affect mental health through chronic environmental exposure and disruption of everyday life. Women may encounter these pressures through caregiving, household resource management, and concerns for family well-being. This study explored reproductive-aged women’s perceptions and experiences of climate-related psychological distress in Qom, Iran. Methods Conventional qualitative content analysis was used. Twenty-five women aged 18–45 years were recruited from health centers, universities, parks, and other community settings using maximum-variation purposive sampling. Variations were sought in age, marital status, education, occupational status, and recruitment setting. Semi-structured interviews were conducted and analysed inductively in Persian. Saturation was reached after interview 17 and confirmed through eight additional interviews. Results Four themes, nine categories, and 17 subcategories were developed: Living with a disrupted and increasingly insecure environment; consequences of climate change in everyday life; climate-related psychological distress; and social consequences of climate change for mental health. Participants linked heat, drought, water insecurity, salinity, dust, and air pollution with bodily discomfort; household and livelihood pressures; emotional responses such as fear, irritability, and place-based grief; cognitive preoccupation with caregiving, resources, and future liveability; moral self-monitoring during household water use; and family tension. Major conclusions Climate-related psychological distress emerged as a cumulative, situated response with interrelated emotional, cognitive, and moral manifestations embedded in environmental, bodily, material, caregiving, relational, and place-based contexts. These responses should not automatically be pathologized. The findings support the co-design and evaluation of locally tailored responses that integrate psychosocial support with practical adaptation across primary care, university, and community settings.