Quality of Life scores across waves, per sex.

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.

据估算，全球每五名冲突后地区居民中，便有一人存在精神健康问题。作为一项重大公共卫生议题，此类精神健康问题会对冲突后个体、社区乃至社会的正常运转造成负面影响。明确此类人群的精神健康问题患病率，对于制定优先级并指导未来的精神健康干预措施至关重要。本研究首次采用重复横断面设计与性别分层分析，旨在估算刚果民主共和国卡萨伊省冲突后人群中抑郁症（PHQ-9）与焦虑症（GAD-7）的患病率。本研究同时评估了生活质量（WHO-QoL-BREF）的多个维度，以深入了解生物-心理-社会应激源与精神健康状况之间的关联。研究采用整群随机抽样方法，分两波收集数据，间隔时长为一年，共纳入385名参与者。两波数据合并后的患病率为：重度抑郁症34.3%，广泛性焦虑障碍26.5%。多变量线性回归分析结果显示，女性身份、较高年龄以及较低的躯体生活质量均可预测抑郁症与焦虑症的发生，但时间推移并无此预测作用。针对两类精神健康结局，环境生活质量均可显著预测女性的精神健康状况，但对男性无此预测效果。综上，本研究结果表明，精神健康服务的匮乏以及持续暴露于日常应激源，与研究人群中精神健康问题长期处于高发状态密切相关。该地区亟需加强精神健康服务体系建设，此类服务不应仅局限于生物医学干预，还应纳入兼顾（精神）健康社会决定因素的多部门协作模式。