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

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 ( = 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%; = -11.37, < 0.001), whereas anxiety symptoms decreased from the baseline (36.33%) to follow-up (24.90%; = 4.06, < 0.001). The final generalised estimating equation model showed that anxiety symptoms decreased over time ( = -3.92, < 0.001), while depression symptoms increased ( = 4.79, < 0.001). Stigmatisation related to Ebola positively predicted anxiety ( = 5.41, < 0.001) and depression symptoms ( = 0.4452, = 0.009). Social support negatively predicted anxiety ( = -1.13, = 0.004) and depression ( = -0.98, < 0.001) symptoms but only moderated the association between stigmatisation and depression symptoms ( = -0.67, < 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.