1 Title: Extreme Climate Related Disasters: two-time points evaluation of the impact in children and youth mental health Sabrina de Sousa Magalhães 1 , Leandro Fernandes Malloy-Diniz 2 , Daniela Valadão Rosa 1 , Antônio Alvim-Soares 2 , Débora Marques de Miranda 1,3 , Marco Aurélio Romano-Silva 1,2 1- Laboratory of Neuroscience and Molecular Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil; 2- Mental Health Department, Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil; 3- Department of Pediatrics, Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil. Corresponding author: Debora Marques de Miranda debora.m.miranda@gmail.com ORCID: https://orcid.org/0000-0002-7081-8401 Acknowledgments: Financial support: CNPq 404047/2013-0 and CAPES/Brazil. Abstract Worldwide, floods and drought are the most frequent extreme climate-related disasters with a potential that might affect children and adolescent mental health. This study aimed to describe mental health impact on youth exposed to flood or drought (time 1), to provide a prospective follow up of symptoms (time 2), about 15 months apart, and to compare the child response with control groups based on ranges of socioeconomic status. Posttraumatic stress symptoms (PTSS) and general behavior problems were evaluated. Sociodemographic data from 275 children and adolescents (6 to 18 years old) were described and analyzed and they were gathered in four groups Control group with higher socioeconomic status, Control group with lower socioeconomic status, Flood group, and Drought group. At time point 1, children from all groups did not substantially differ in general behavioral problems, but PTSS scores significantly differentiate the groups. At time point 2, the Flood group presented a pattern of recovery about PTSS. For the Drought group, a persistence and stability pattern of PTSS was verified. Post-disaster longitudinal studies are essential to elucidate how psychological distress progress over time and to understand the relationship between mental health and exposure to trauma. Keywords: climate change; mental health; drought; flood; youth.