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Record W4414208194 · doi:10.1192/j.eurpsy.2025.537

The weight of office? A systematic scoping review of mental health issues and risk factors in elected politicians across democratic societies

2025· article· en· W4414208194 on OpenAlexaboutno aff
Alexander Smith, Stefanie Hachen, Ashley Weinberg, Peter Falkai, Sissel Guttormsen, Michael Liebrenz

Bibliographic record

VenueEuropean Psychiatry · 2025
Typearticle
Languageen
FieldPsychology
TopicResilience and Mental Health
Canadian institutionsnot available
Fundersnot available
KeywordsMental healthHarmPsychopathologySystematic reviewTollSpeculationPsychological interventionDemocracyEmpirical research

Abstract

fetched live from OpenAlex

Introduction The mental health status and capacity to govern of democratically-elected politicians have become significant topics of interest, which have attracted speculation in the media and beyond. In fulfilling demanding and high-stress positions, politicians could encounter distinctive risk factors that may harm their mental wellbeing, yet existing research literature about this topic remains underexplored. Objectives This scoping review aimed to systematically examine the breadth of available evidence on mental health issues and risk factors affecting democratically-elected politicians and to identify future research needs. Methods Using pre-defined eligibility criteria based on JBI guidelines, a systematic keyword search was conducted in May 2024 of MEDLINE, Scopus, and APA PsycNet, supplemented by snowballing techniques. Only studies reporting primary, empirical evidence on mental ill-health or risk factors with adverse psychological correlates from serving politicians in “Full” or “Flawed” democracies (per the Democracy Index) were included from 1999-2024. Titles and abstracts were screened and the full-text of potentially eligible literature was assessed before data extraction and synthesis. Results Eighteen sources met the eligibility criteria, cumulatively encompassing ~3,500 politicians across seven democracies, namely: Australia, Canada, the Netherlands, Norway, New Zealand, the United Kingdom, and the United States. Four sources (22.2%) explored general psychopathology trends, revealing varying but sizeable rates of mental ill-health and high-risk alcohol consumption. The other fourteen studies (77.8%) provided evidence on risk factors; twelve underlined the psychological toll of violence and two investigations highlighted the injurious effects of specific occupational conditions. Notably, exposure to violence often precipitated detrimental mental health outcomes, with certain data indicating a disproportionate impact on female officeholders. Conclusions Existing research literature suggests that democratically-elected politicians face considerable mental health challenges, especially from the effects of violence. However, there are notable research gaps with a paucity of reliable prevalence estimates, intervention studies, and work on national leaders. Equally, the underrepresentation of numerous democratic countries accentuates the need for a more diverse evidence-base to better support the mental wellbeing of politicians worldwide. Disclosure of Interest None Declared

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.032
metaresearch head score (Gemma)0.120
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.032
Threshold uncertainty score0.168

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0320.120
Meta-epidemiology (narrow)0.0020.002
Meta-epidemiology (broad)0.0110.007
Bibliometrics0.0320.029
Science and technology studies0.0020.002
Scholarly communication0.0070.006
Open science0.0030.004
Research integrity0.0040.002
Insufficient payload (model declined to judge)0.0060.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.013
GPT teacher head0.389
Teacher spread0.376 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designSystematic review
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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