Seekles Maaike L, Kadima Jacob K, Omumbu Pierre O L, Kukola Junior K, Kim Joy J, Bulambo Christian B, Mulamba Raphael M, Nganda Motto, Dean Laura
Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
The Leprosy Mission DRC, Kinshasa, Democratic Republic of the Congo.
PLOS Glob Public Health. 2025 Jan 9;5(1):e0004057. doi: 10.1371/journal.pgph.0004057. eCollection 2025.
Globally, one in five people in post-conflict areas are estimated to be living with a mental health condition. As a key public health issue, these conditions negatively affect individuals, communities, and societies to function after a conflict. Documenting the prevalence of mental health conditions amongst these populations is crucial to prioritise and guide future mental health interventions. This study was the first to use a repeated cross-sectional design and sex-disaggregated analysis, with the aim of estimating the prevalence of depression (PHQ-9) and anxiety (GAD-7) in a post-conflict population of the Kasai Province, Democratic Republic of the Congo. Several domains of Quality of life (WHO-QoL-BREF) were also assessed to gain insight into the relationship between bio-psychosocial stressors and mental health status. Using random cluster sampling, data were collected in two waves from 385 participants, with a one-year interval. The pooled prevalence across both waves was 34.3% for major depression disorder and 26.5% for generalised anxiety disorder. Multivariable linear regression analysis showed that depression and anxiety were both predicted by being female, being of older age, and by experiencing lower physical quality of life, but not by the passing of time. For both mental health outcomes, environmental quality of life served as a significant predictor for women, but not for men. In conclusion, these results suggest that a lack of mental health services and continued exposure to daily stressors are linked to a sustained high prevalence of mental health conditions in our study population. There is a significant need for the development of mental health services in the region. These services should go beyond biomedical interventions and include multi-sectoral approaches that consider the social determinants of (mental) health.
据估计，全球冲突后地区每五人中就有一人患有心理健康问题。作为一个关键的公共卫生问题，这些问题对冲突后的个人、社区和社会功能产生负面影响。记录这些人群中心理健康问题的患病率对于确定未来心理健康干预措施的优先级和提供指导至关重要。本研究首次采用重复横断面设计和按性别分类的分析方法，旨在估计刚果民主共和国开赛省冲突后人群中抑郁症（PHQ-9）和焦虑症（GAD-7）的患病率。还评估了生活质量的几个领域（世界卫生组织生活质量简表），以深入了解生物心理社会压力源与心理健康状况之间的关系。采用随机整群抽样方法，对385名参与者分两波进行数据收集，间隔为一年。两波数据汇总后的重度抑郁症患病率为34.3%，广泛性焦虑症患病率为26.5%。多变量线性回归分析表明，女性、年龄较大以及身体生活质量较低是抑郁症和焦虑症的预测因素，但与时间推移无关。对于这两种心理健康结果，生活环境质量是女性心理健康的重要预测因素，而对男性则不然。总之，这些结果表明，缺乏心理健康服务以及持续暴露于日常压力源与我们研究人群中心理健康问题的持续高患病率有关。该地区迫切需要发展心理健康服务。这些服务应超越生物医学干预，包括考虑（心理）健康社会决定因素的多部门方法。
