Mental distress before and during the COVID-19 pandemic: A longitudinal study among communities affected by Ebola virus disease in the DR Congo

Cénat, Jude Mary; Farahi, Seyed Mohammad Mahdi Moshirian; Dalexis, Rose Darly; Darius, Wina Paul; Bukaka, Jacqueline; Balayulu-Makila, Oléa; Luyeye, Noble; Dérivois, Daniel; Rousseau, Cécile

doi:10.1016/j.psychres.2022.114654

Cited by 7 publications

(6 citation statements)

References 32 publications

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“…This contradicts findings from adult samples, where exposure to EVD is a significant predictor of mental distress. 7 – 10 , 11 – 15 , 16 – 37 These results may reflect youth being less worried than adults by actual threats, which they may minimise, and more affected by the impact of an epidemic on their relational and social environment and on their development into young adults. The wide variability in exposure to EVD among participants may also explain this result; some participants had infected relatives, whereas others had barely heard of the virus.…”

Section: Discussionmentioning

confidence: 96%

“…The prevalence of anxiety symptoms in adolescents at T 1 and T 2 in our study was higher than those reported for adult populations affected by EVD in previous studies. 10 – 14 A meta-analysis showed that 14% of EVD survivors experienced significant symptoms of anxiety, 33 whereas a study in Sierra Leone of adult EVD survivors and healthcare workers found that 83.3% of survivors met criteria for a diagnosis of anxiety. 35 However, other studies have been more consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

“… 41 Preventing stigma is thus vital in preventing mental health problems, as studies consistently show that it is the most important predictor of different mental health issues in the context of EVD, including anxiety, depression, PTSD and mental distress. 8 – 10 …”

Section: Discussionmentioning

confidence: 99%

“…A stigmatisation related to EVD and COVID-19 scale has been widely used in the DRC Ebola and COVID-19 context. 9 -- 10 -- 28 , 29 It includes 20 items with a five-point Likert response type, ranging from ‘never’ (0) to ‘always’ (4), e.g., ‘Someone refused to talk to you … ’; ‘A company refused to hire you … ’. Cronbach's α in the current sample was 0.97 at baseline and 0.98 at follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…Studies conducted in different DRC provinces affected by EVD have found high prevalence rates of depression, psychological distress and post-traumatic stress disorder (PTSD) symptoms among adults. 7 – 10 For instance, studies conducted in health zones affected by EVD in the Equateur Province reported that 62.03, 45.58 and 58.81% of adults experienced symptoms of depression, psychological distress and PTSD, respectively. 9 – 11 In addition, studies conducted in the DRC Eastern regions found that 23.5 to 24.3% of adults experienced symptoms of depression, and 24.1 to 53.7% exhibited symptoms of PTSD.…”

mentioning

confidence: 99%

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Prevalence and determinants of anxiety, depression and comorbid anxiety–depression symptoms among adolescents in Ebola-affected zones

Cénat,

Dromer,

Mistry

et al. 2023

BJPsych open

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Background Ebola virus disease (EVD) has been shown to be associated with poor mental health in affected zones. However, no study has yet explored its impact on adolescents’ mental health. Aims This study aimed to assess the prevalence and risk factors associated with depression and anxiety symptoms among adolescents in EVD-affected areas in the Equateur Province of the Democratic Republic of the Congo during the COVID-19 pandemic. Method A provincial sample of adolescents aged 12–17 years (M = 14.84, s.d. = 1.49) living in the 18 urban and rural areas affected by the 2018 EVD outbreak completed a two-wave longitudinal survey. Surveys assessed symptoms of depression and anxiety, exposure to Ebola, social support and sociodemographic information. Results A total of 490 participants completed the baseline and follow-up surveys, 50% of whom were female. Elevated and worsened depressive symptoms were observed among participants from the baseline (56.94%) to the follow-up (91.43%; z = −11.37, P < 0.001), whereas anxiety symptoms decreased from the baseline (36.33%) to follow-up (24.90%; z = 4.06, P < 0.001). The final generalised estimating equation model showed that anxiety symptoms decreased over time (B = −3.92, P < 0.001), while depression symptoms increased (B = 4.79, P < 0.001). Stigmatisation related to Ebola positively predicted anxiety (B = 5.41, P < 0.001) and depression symptoms (B = 0.4452, P = 0.009). Social support negatively predicted anxiety (B = −1.13, P = 0.004) and depression (B = −0.98, P < 0.001) symptoms but only moderated the association between stigmatisation and depression symptoms (B = −0.67, P < 0.001). Conclusions Most adolescents living in EVD-affected areas experience mental health issues. Stigmatisation related to EVD and living in urban areas are the most consistent predictors of mental health problems. Nevertheless, social support remains a protective factor for depression and anxiety symptoms and a necessary resource for building resilience.

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