BACKGROUND: Countries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations' health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes. METHODS: Literature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered. RESULTS: One-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours. CONCLUSION: On the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.

Aventura Social ISAMB University of Lisbon and Lisbon Lusíada University Lisbon Portugal

Department of Mental Health Medical School Nova University Lisbon Lisbon Portugal

European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal

Faculty of Human Kinetics ISAMB University of Lisbon Lisbon Portugal

Institute of Active Lifestyle Faculty of Physical Culture Palacky University Olomouc Olomouc Czech Republic

Medical School CMDT Nova University Lisbon Lisbon Portugal

Psychiatry Department Faculty of Medicine University of Lisbon Lisbon Portugal

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