The Impact of Natural Disasters on Psycho-neuroendocrine Dysregulation in Adult Survivors: A Systematic Review

Abstract

Background: Natural disasters constitute extreme stressors that can disrupt psychological functioning as well as the biological systems regulating stress responses. However, scientific evidence on the psycho- neuroendocrinological effects of natural disaster exposure remains fragmented and has not yet been systematically integrated. Methods: In order to identify studies published between 2015 and 2025, a systematic literature search was conducted using the PubMed and ScienceDirect databases. Observational studies assessing mental health outcomes and neuroendocrine or neurobiological markers among natural disaster survivors were included. The heterogeneity of study designs and outcome measures necessitated the extraction and narrative synthesis of data. Results: The inclusion criteria were met by a total of 29 studies. Exposure to natural disasters was consistently linked to post-traumatic stress disorder (PTSD), despondency, anxiety, and sleep disturbances, with the consequences of these conditions lasting for up to two decades after the disaster. In individuals with severe PTSD, the Hypothalamic–Pituitary–Adrenal (HPA) axis dysregulation was observed, which was characterized by reduced levels of Brain-Derived Neurotrophic factor (BDNF) and serotonin, as well as changes in brain structure and network connectivity, including a reduction in hippocampal volume. Additionally, these psycho-neuroendocrine effects were linked to an elevated risk of cardiovascular disease and other chronic conditions. Conclusion: Natural disasters exert complex and long-lasting psycho-neuroendocrinological effects through interactions among psychological, neural, and endocrine factors. Integrated and sustained post-disaster recovery approaches are essential to improve long-term health outcomes among survivors.