Secor Andrew, Macauley Rose, Stan Laurentiu, Kagone Meba, Sidikiba Sidibe, Sow Sadou, Aronovich Dana, Litvin Kate, Davis Nikki, Alva Soumya, Sanderson Jeff
JSI Research and Training Institute Inc, Monrovia, Liberia
Department of Global Health, University of Washington, Seattle, Washington, USA.
BMJ Open. 2020 May 26;10(5):e035217. doi: 10.1136/bmjopen-2019-035217.
To describe the prevalence and correlates of depression and anxiety among adult Ebola virus disease (EVD) survivors in Liberia, Sierra Leone and Guinea.
Cross-sectional.
One-on-one surveys were conducted in EVD-affected communities in Liberia, Sierra Leone and Guinea in early 2018.
1495 adult EVD survivors (726 male, 769 female).
Patient Health Questionnaire-9 (PHQ-9) depression scores and Generalised Anxiety Disorder-7 (GAD-7) scores.
Prevalence and severity of depression and anxiety varied across the three countries. Sierra Leone had the highest prevalence of depression, with 22.0% of participants meeting the criteria for a tentative diagnosis of depression, compared with 20.2% in Liberia and 13.0% in Guinea. Sierra Leone also showed the highest prevalence of anxiety, with 10.7% of participants meeting criteria for generalized anxiety disorder (GAD-7 score ≥10), compared with 9.9% in Liberia and 4.2% in Guinea. Between one-third and one-half of respondents reported little interest or pleasure in doing things in the previous 2 weeks (range: 47.0% in Liberia to 37.6% in Sierra Leone), and more than 1 in 10 respondents reported ideation of self-harm or suicide (range: 19.4% in Sierra Leone to 10.4% in Guinea). Higher depression and anxiety scores were statistically significantly associated with each other and with experiences of health facility-based stigma in all three countries. Other associations between mental health scores and respondent characteristics varied across countries.
Our results indicate that both depression and anxiety are common among EVD survivors in Liberia, Sierra Leone and Guinea, but that there is country-level heterogeneity in prevalence, severity and correlates of these conditions. All three countries should work to make mental health services available for survivors, and governments and organisations should consider the intersection between EVD-related stigma and mental health when designing programmes and training healthcare providers.
描述利比里亚、塞拉利昂和几内亚成年埃博拉病毒病（EVD）幸存者中抑郁症和焦虑症的患病率及其相关因素。
横断面研究。
2018年初在利比里亚、塞拉利昂和几内亚受埃博拉病毒病影响的社区进行了一对一调查。
1495名成年埃博拉病毒病幸存者（726名男性，769名女性）。
患者健康问卷-9（PHQ-9）抑郁评分和广泛性焦虑障碍-7（GAD-7）评分。
三个国家中抑郁症和焦虑症的患病率及严重程度各不相同。塞拉利昂抑郁症患病率最高，22.0%的参与者符合抑郁症初步诊断标准，相比之下，利比里亚为20.2%，几内亚为13.0%。塞拉利昂焦虑症患病率也最高，10.7%的参与者符合广泛性焦虑障碍标准（GAD-7评分≥10），相比之下，利比里亚为9.9%，几内亚为4.2%。三分之一至二分之一的受访者表示在过去两周内对做事几乎没有兴趣或乐趣（范围：利比里亚为47.0%，塞拉利昂为37.6%），超过十分之一的受访者表示有自残或自杀念头（范围：塞拉利昂为19.4%，几内亚为10.4%）。在所有三个国家，较高的抑郁和焦虑评分在统计学上彼此显著相关，且与基于医疗机构的耻辱经历相关。心理健康评分与受访者特征之间的其他关联因国家而异。
我们的结果表明，抑郁症和焦虑症在利比里亚、塞拉利昂和几内亚的埃博拉病毒病幸存者中都很常见，但这些疾病的患病率、严重程度及其相关因素在国家层面存在异质性。所有三个国家都应努力为幸存者提供心理健康服务，政府和组织在设计项目和培训医疗保健提供者时应考虑与埃博拉病毒病相关的耻辱与心理健康之间的交叉问题。
