Iraq is among the countries most vulnerable to climate change, and it is faced with extreme heat, drought and environmental degradation.

To examine the prevalence of climate anxiety and its association with depression and generalised anxiety disorder in the Iraqi population.

A cross-sectional survey recruited 1019 adult participants (47.8% males, 52.2% females). Most participants were aged 18–41 years (n = 854, 83.8%); 16.2% (n = 165) were aged 42–72 years. Regionally, 75.6% (n = 770) were from the Kurdistan Region and 24.4% (n = 249) from provinces in central and southern Iraq. The study used the Climate Change Anxiety Scale (CCAS), Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Statistical analyses, included descriptive analysis, analysis of variance (ANOVA), t-tests, Pearson’s correlations and regression models, examined variations in climate anxiety by demographics and associations with depression and anxiety.

Overall, 71.4% of participants reported severe climate anxiety, with a higher prevalence in the Kurdistan Region (73.2%) compared with central and southern Iraq (65.9%). Five provinces were found to have significantly higher levels of climate anxiety: Ninawa, Basrah, Najaf, Duhok and Erbil. Age was a significant predictor, and older participants (42–72 years) reported higher levels than younger participants (P = 0.008). A positive correlation was observed between climate anxiety and both depression (r = 0.382, P < 0.001) and generalised anxiety (r = 0.361, P < 0.001). Simple linear regression revealed that climate anxiety was significantly associated with both depression (β = 0.25, P < 0.001) and generalised anxiety (β = 0.214, P < 0.01), accounting for the 14.6 and 13% variance, respectively.

Climate anxiety is prevalent in Iraq and significantly associated with mental health problems. The findings endorse the need for integration of mental health into Iraq’s national climate adaptation and public health policies.