Symptoms and determinants of post-traumatic stress disorder and psychological distress among adolescents in Ebola virus disease affected areas: a longitudinal design.

Ebola Virus Disease (EVD) profoundly impacts individuals and communities, causing psychological distress, and social stigma. EVD outbreaks are strongly associated with posttraumatic stress due to their high fatality rate, social isolation, due to the fear of infection, of transmitting the virus to loved ones, and of dying. However, limited research explores the mental health of children in EVD-affected areas, highlighting critical gaps. This research aims to document symptoms and determinants of post-traumatic stress disorder (PTSD) and psychological distress among adolescents living in EVD-affected health zones in the Democratic Republic of the Congo (DRC). A two-wave longitudinal study was conducted in Équateur province (March-April 2019 and August-September 2020), DRC, using stratified sampling to recruit 493 adolescents (50.1% girls). Participants completed measures assessing PTSD and psychological distress symptoms, EVD exposure, EVD-related stigma, life traumatic experiences, peritraumatic distress, and sociodemographics. The prevalence of symptoms of PTSD rose from 19.27 to 30.63%, and psychological distress increased from 39.35 to 59.43% between baseline and follow-up. Rural residents had higher PTSD (33.41%) and psychological distress (61.10%) rates compared to urban residents (8.93% and 46.43%, respectively), but there were no gender differences. Generalized estimating equation (GEE) analyses revealed increases in PTSD and psychological distress over time (B = 7.76, p <.001; B = 4.77, p <.001), linked to EVD-related stigmatization (B = 3.78, p <.001; B = 2.54, p <.001), peritraumatic distress (B = 1.50, p =.012; B = 2.36, p <.001), and witnessed life events (B = 1.43, p =.006; B = 0.74, p =.004). Sociodemographic factors, including rural residence and parental unemployment status, were significant predictors. The study documents a significant rise in PTSD and psychological distress among adolescents in EVD-affected regions of the DRC, which underscores the urgent need for sustainable mental health services, stigma reduction programs, and culturally sensitive interventions, particularly in rural areas.