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Berthail B, Trousselard M, Lecouvey G, Le Roy B, Fraisse F, Peschanski D, Eustache F, Gagnepain P, Dayan J. Differences in predictive factors for post-traumatic stress disorder encompassing partial PTSD and full PTSD: a cross-sectional study among individuals exposed to the November 13, 2015 Paris attacks. Front Psychiatry 2024; 15:1351695. [PMID: 38606406 PMCID: PMC11007703 DOI: 10.3389/fpsyt.2024.1351695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/26/2024] [Indexed: 04/13/2024] Open
Abstract
Background When faced with a surge of physically injured individuals, especially following a traumatic event like an attack, frontline practitioners prioritize early triage. Detecting potential psychological injuries soon after such events remains challenging. Some individuals might develop post-traumatic stress disorder (PTSD) according to DSM-V criteria. Others may exhibit PTSD symptoms without meeting full diagnostic criteria, termed partial or sub-syndromal PTSD, a less-explored area in literature. This study aims to identify predictive factors for both full and partial PTSD. Method In a cohort of victims of the 2015 Paris attacks, multinomial logistic regressions explored predictive factors for partial or full PTSD status 8 to 18 months post-attacks. Analyses considered pre, peri, and posttraumatic factors chosen from literature review and univariate analysis within each group. Results Within the cohort, 50 individuals showed no signs of PTSD, 35 experienced partial PTSD, and 30 presented with full PTSD. After logistic regression, risk factors associated with full PTSD included a history of trauma (OR = 1.30, CI [1.02-1.66], p < 0.05), the intensity of peri-traumatic physical reactions (OR = 1.22, CI [1.09-1.36], p < 0.001), the difficulties in suppressing intrusive thoughts (OR = 1.11, CI [1.02-1.21], p < 0.013). Only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD (OR = 1.13, [CI 1.02-1.24], p < 0.001). Discussion This study revealed that a history of trauma, the intensity of peri-traumatic physical reactions (e.g., tachycardia, trembling, flushes, numbness.), and the difficulties in suppressing intrusive thoughts constitute risk factors for the development of full PTSD. Moreover, the study identified that only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD. These findings seem to underscore the significance of peri-traumatic experiences in influencing the development of post-traumatic stress symptoms. Conclusion This study emphasizes the significance of examining peri-traumatic reactions in PTSD development, suggesting its potential as a straightforward screening tool for post-traumatic stress disorder. It also underscores the influence of prior traumatic experiences, before de novo traumatization, in shaping vulnerability to PTSD and illuminates the crucial role of compromised control of intrusive thoughts that could perpetuate PTSD.
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Affiliation(s)
- Benoit Berthail
- French Military Health Service Academy, Ecole du Val de Grace, 1 Place Alphonse Laveran, Paris, France
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Marion Trousselard
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
- University of Lorraine, Inserm, INSPIIRE UMR 1319, F-54000, Nancy, France
| | - Gregory Lecouvey
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Barbara Le Roy
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Florence Fraisse
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Denis Peschanski
- Paris I Pantheon Sorbonne University, HESAM University , EHESS, CNRS, UMR8209, Paris, France
| | - Francis Eustache
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Pierre Gagnepain
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Jacques Dayan
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
- Child and Adolescent Psychiatry University Hospital Pole, Guillaume Régnier Hospital Center, Rennes 1 University, 35700 Rennes, France
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Ngamaba KH, Lombo LS, Makopa IK, Webber M, Liuta JM, Madinga JN, Mampunza SMM, Heap C. Mental health outcomes, literacy and service provision in low- and middle-income settings: a systematic review of the Democratic Republic of the Congo. NPJ MENTAL HEALTH RESEARCH 2024; 3:9. [PMID: 38609473 PMCID: PMC10956021 DOI: 10.1038/s44184-023-00051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/20/2023] [Indexed: 04/14/2024]
Abstract
In the Democratic Republic of the Congo (DRC), the prevalence of mental health issues could be greater than in other low-income and middle-income countries because of major risk factors related to armed conflicts and poverty. Given that mental health is an essential component of health, it is surprising that no systematic evaluation of mental health in the DRC has yet been undertaken. This study aims to undertake the first systematic review of mental health literacy and service provision in the DRC, to bridge this gap and inform those who need to develop an evidence base. This could support policymakers in tackling the issues related to limited mental health systems and service provision in DRC. Following Cochrane and PRISMA guidelines, a systematic (Web of Science, Medline, Public Health, PsycINFO, and Google Scholar) search was conducted (January 2000 and August 2023). Combinations of key blocks of terms were used in the search such as DRC, war zone, mental health, post-traumatic stress disorder (PTSD), anxiety, depression, sexual violence, war trauma, resilience, mental health systems and service provision. We followed additional sources from reference lists of included studies. Screening was completed in two stages: title and abstract search, and full-text screening for relevance and quality. Overall, 50 studies were included in the review; the majority of studies (n = 31) were conducted in the Eastern region of the DRC, a region devastated by war and sexual violence. Different instruments were used to measure participants' mental health such as the Hopkins Symptoms Checklist (HSCL-25), The Harvard Trauma Questionnaire, Patient Health Questionnaire (PHQ-9); General Anxiety Disorder (GAD-7), and Positive and Negative Symptoms Scale (PANSS). Our study found that wartime sexual violence and extreme poverty are highly traumatic, and cause multiple, long-term mental health difficulties. We found that depression, anxiety, and PTSD were the most common problems in the DRC. Psychosocial interventions such as group therapy, family support, and socio-economic support were effective in reducing anxiety, depression, and PTSD symptoms. This systematic review calls attention to the need to support sexual violence survivors and many other Congolese people affected by traumatic events. This review also highlights the need for validating culturally appropriate measures, and the need for well-designed controlled intervention studies in low-income settings such as the DRC. Better public mental health systems and service provision could help to improve community cohesion, human resilience, and mental wellbeing. There is also an urgent need to address wider social issues such as poverty, stigma, and gender inequality in the DRC.
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Affiliation(s)
- Kayonda Hubert Ngamaba
- International Centre for Mental Health Social Research, Social Policy and Social Work, School for Business and Society, University of York, Heslington, York, YO10 5DD, UK.
| | - Laddy Sedzo Lombo
- Centre Spécialisé dans la Prise en charge Psychosociale en Santé Mentale (CSPEMRDC), Université Chrétienne de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Israël Kenda Makopa
- Neuropsychiatre et Addictologue Centre Spécialisé dans la Prise en charge Psychosociale en Santé Mentale (CSPEMRDC), Université Chrétienne de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Martin Webber
- International Centre for Mental Health Social Research, Social Policy and Social Work, School for Business and Society, University of York, Heslington, York, YO10 5DD, UK
| | - Jack M Liuta
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Joule Ntwan Madinga
- WHO Country Office DRC & Medical Parasitology and Epidemiology, Faculty of Medicine, University of Kikwit, Kikwit, Democratic Republic of Congo
| | - Samuel Ma Miezi Mampunza
- Faculte de Medicine University of Kinshasa & Université Protestante au Congo (UPC), Kinshasa, Democratic Republic of Congo
| | - Cheyann Heap
- International Centre for Mental Health Social Research, Social Policy and Social Work, School for Business and Society, University of York, Heslington, York, YO10 5DD, UK
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Alpay EH, Aydın A. Effects of peritraumatic reactions on post-traumatic stress among Kahramanmaras earthquake survivors. Nord J Psychiatry 2024; 78:153-161. [PMID: 38165775 DOI: 10.1080/08039488.2023.2291548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/01/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE Peritraumatic reactions play a crucial role in the development of mental health problems, including depression and post-traumatic stress disorder. Therefore, this study sought to examine the influence of the peritraumatic reactions, including peritraumatic dissociation, peritraumatic distress, mental defeat, and tonic immobility, on post-traumatic stress disorder and major depressive disorder in earthquake survivors. MATERIALS AND METHODS A total of 261 adult participants aged between 18 and 65 (Mage=29.20, SD = 28.06, 162 were female, and 99 were male) who were exposed to the Kahramanmaras earthquake in February 2023 were recruited in the study. Data were collected between April 10 and 18 2023, two months after the earthquake. Participants completed questionnaires, including The International Trauma Questionnaire, The International Depression Questionnaire, The Mental Defeat Questionnaire, The Tonic Immobility Scale, and The Peritraumatic Dissociative Experiences Questionnaire. RESULTS Two-step multiple linear regression analyses indicated all peritraumatic reactions predicted both post-traumatic stress disorder and depression. Dominance analysis results showed that the contribution of peritraumatic dissociation in predicting PTSD and depression was higher among other peritraumatic reactions. CONCLUSION The findings of the study revealed a robust association between peritraumatic reactions and both depression and PTSD, shedding light on the underlying processes in the development of trauma-related disorders. Early assessment of peritraumatic reactions may be useful in identifying individuals at risk of developing PTSD and depression.
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Affiliation(s)
- Emre H Alpay
- Department of Psychology, Mersin University, Mersin, Türkiye
| | - Arzu Aydın
- Department of Psychology, Mersin University, Mersin, Türkiye
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Zylberstajn C, Messina Coimbra B, Oliveira-Watanabe TT, Rangel Maciel M, Calsavara VF, Olff M, Feijo Mello M, Feijo Mello A. The Relationship between Lifetime Exposure to Potentially Traumatic Events, Peritraumatic Dissociation, and PTSD in a Sample of Sexually Assaulted Women in Sao Paulo, Brazil. J Trauma Dissociation 2023; 24:252-267. [PMID: 36271690 DOI: 10.1080/15299732.2022.2136326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sexually assaulted women represent a particularly high-risk group for developing post-traumatic stress disorder (PTSD). Potentially traumatic events (PTEs) and peritraumatic dissociation (PD) are known risk factors for PTSD. However, little is known about how previous trauma affects PD and how this relationship affects PTSD. We aimed to investigate whether PD acts as a mediator between PTEs and PTSD severity in a sample of recently sexually assaulted women in Sao Paulo, Brazil. Seventy-four sexually assaulted women aged 18-44 completed questionnaires and structured interviews on PTSD, PD, and PTEs. We examined direct and indirect effects of variables using causal mediation analysis. Lifetime exposure to PTEs was a risk factor for PD, but PD was not a risk factor for PTSD symptom severity. Also, PD was not a mediator between PTEs and PTSD severity. We provided recommendations on how to further explore the relationship between lifetime traumatic exposure, PTSD, and peritraumatic dissociation.
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Affiliation(s)
- Cecilia Zylberstajn
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno Messina Coimbra
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
| | - Thauana T Oliveira-Watanabe
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mariana Rangel Maciel
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Vinicius F Calsavara
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Miranda Olff
- Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Marcelo Feijo Mello
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Andrea Feijo Mello
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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deMello RAF, Coimbra BM, Pedro BDM, Benvenutti IM, Yeh MSL, Mello AF, Mello MF, Poyares DR. Peri-Traumatic Dissociation and Tonic Immobility as Severity Predictors of Posttraumatic Stress Disorder After Rape. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:4240-4266. [PMID: 35899768 DOI: 10.1177/08862605221114151] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Some individuals show abnormal reactions to extreme fear and life-threatening situations, including tonic immobility (TI) and peri-traumatic dissociation (PTD). We aimed to investigate the association of TI and PTD with posttraumatic stress disorder (PTSD) in women who experienced sexual violence and the risk factors for PTD occurrence. We compared PTSD severity in 86 young adult women with PTSD after a sexual violence exposure grouped according to the presence of PTD and TI. In addition, we investigated whether PTD is associated with depression and anxiety symptoms and assessed potential risk factors for PTD reaction. We found a significant positive correlation between PTSD severity and PTD occurrence (R2 = .132; p = .001). PTD was also positively correlated with all clusters of PTSD symptoms except the Clinician-Administered PTSD Scale avoidance cluster (p = .058). PTD was strongly correlated with anxiety (R2 = .619; p < .001) and depressive symptoms (R2 = .547; p < .001). Multiple logistic regression showed that history of physical abuse (odds ratio [OR]: 1.386; p = .011) and sexual abuse (OR: 1.947; p = .004) during childhood were associated with PTD occurrence. Other risk factors for PTD were having less years of study (OR: 0.216; p = .016) and lower income (OR: 7.403; p = .028). TI measures were available for a subsample of 29 women. We found no association between TI and PTSD severity. PTD, but not TI, is significantly associated with more severe PTSD, depressive, and anxiety symptoms. Less-educated women with a history of childhood abuse and a lower income are at risk of PTD occurrence during a sexual violence episode.
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Affiliation(s)
- Ricardo A F deMello
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Bruno Messina Coimbra
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
| | - Bianca D M Pedro
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Isabella M Benvenutti
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Mary S L Yeh
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Andrea F Mello
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo F Mello
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Dalva R Poyares
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Maftei A, Dănilă O, Măirean C. The war next-door-A pilot study on Romanian adolescents' psychological reactions to potentially traumatic experiences generated by the Russian invasion of Ukraine. Front Psychol 2022; 13:1051152. [PMID: 36544444 PMCID: PMC9762354 DOI: 10.3389/fpsyg.2022.1051152] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Romania shares the longest UE border with Ukraine, and since the Russian invasion of Ukraine began, many have been involved in helping the refugees. Consequently, children and adolescents might be directly and indirectly exposed to war-related trauma. In the present exploratory research, we investigated Romanian adolescents' potential risk and protective factors related to the psychological outcomes of war exposure. Our cross-sectional study was conducted shortly after February 24th (i.e., the first invasion day). Methods The sample included 90 Romanian adolescents aged 11 to 15 (M = 12.90, SD = 1.17), residents in Iași, Romania (i.e., 205,7 km from the Ukrainian border). Participants completed self-reported measures of peritraumatic dissociative experiences, knowledge about the conflict in Ukraine, personal, school, and family implications in volunteering/helping behavior, discussions about the conflict, threat perception (self and perceived parental threat), anxiety, social media engagement, resilience, and moral elevation. Results The main findings suggested that participants involved in helping behaviors toward Ukrainian refugees present higher peritraumatic dissociative experiences, anxiety symptoms, and higher moral elevation than boys and participants not involved in these behaviors. Moreover, anxiety symptoms were positively associated with threat perception, peritraumatic dissociation, and social media engagement and negatively related to resilience. Discussions Finally, we discuss the implications of our findings concerning their practical utility in managing peritraumatic exposure to war by using interventions designed to increase adolescents' resilience during difficult times.
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Pang X, Li F, Zhang Y. The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study. Psychol Res Behav Manag 2022; 15:2183-2191. [PMID: 35983022 PMCID: PMC9380830 DOI: 10.2147/prbm.s372660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022] Open
Abstract
Background Post-traumatic stress disorder (PTSD) can manifest in individuals following a traumatic event. There is a paucity of studies focusing on PTSD symptoms in ovarian cancer (OC) patients. This study aimed to investigate the association of social support, mental adjustment and PTSD symptoms in Chinese OC patients with a view to exploring whether mental adjustment could mediate the relationship. Methods A cross-sectional study was conducted from January 2015 to December 2016. A total of 171 OC subjects were recruited and the effective response rate was 81.3%. The PTSD Checklist-Civilian Version (PCL-C), Mini-Mental Adjustment to Cancer scale (Mini-MAC) and Duke-UNC Functional Social Support Questionnaire were disseminated to the patients. The Chinese Mini-MAC was used in this study focusing on three components, namely negative emotion, positive attitude, and cognitive avoidance. Hierarchical linear regression analyses were employed to investigate the association of social support and PTSD symptoms, and the role of mental adjustment in their mediation. Results The prevalence of PTSD symptoms was 17.3% in OC patients. PTSD symptoms were negatively related with both social support and positive attitude, and positively associated with negative emotion and cognitive avoidance. Social support was negatively associated with negative emotion and cognitive avoidance, and positively related with positive attitude. In addition, negative emotion and positive attitude mediated the association between social support and PTSD symptoms. Conclusion PTSD symptoms in OC patients should be paid attention to. Social support and mental adjustment were positive resources associated with PTSD symptoms. Moreover, mental adjustment could mediate the relation between social support and PTSD symptoms in OC patients. Therefore, intervention management that focusing on improving perceived social support as well as strengthening mental adjustment, especially negative emotion and positive attitude, may be useful for reducing PTSD symptoms in this context.
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Affiliation(s)
- Xiaoyan Pang
- Department of Gynecology, the First Hospital of China Medical University, Shenyang, Liaoning, 110001, People's Republic of China
| | - Fangmei Li
- Department of Gynecology, the First Hospital of China Medical University, Shenyang, Liaoning, 110001, People's Republic of China
| | - Yi Zhang
- Department of Gynecology, the First Hospital of China Medical University, Shenyang, Liaoning, 110001, People's Republic of China
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Vivalya BMN, Vagheni MM, Kitoko GMB, Vutegha JM, Kalume AK, Piripiri AL, Masika YD, Mbeva JBK. Developing mental health services during and in the aftermath of the Ebola virus disease outbreak in armed conflict settings: a scoping review. Global Health 2022; 18:71. [PMID: 35836283 PMCID: PMC9281256 DOI: 10.1186/s12992-022-00862-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 06/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background Mental health is mostly affected by numerous socioeconomic factors that need to be addressed through comprehensive strategies. The aftermath of armed conflict and natural disasters such as Ebola disease virus (EVD) outbreaks is frequently associated with poor access to mental healthcare. To design the basis of improving mental health services via the integration of mental health into primary health care in the Democratic Republic of Congo (DRC), we conducted a scoping review of available literature regarding mental illness in armed conflict and EVD outbreak settings. Methods This scoping review of studies conducted in armed conflict and EVD outbreak of DRC settings synthesize the findings and suggestions related to improve the provision of mental health services. We sued the extension of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to scoping studies. A mapping of evidence related to mental disorders in the eastern part of DRC from studies identified through searches of electronic databases (MEDLINE, Scopus, Psych Info, Google Scholar, and CINAHL). Screening and extraction of data were conducted by two reviewers independently. Results This review identified seven papers and described the findings in a narrative approach. It reveals that the burden of mental illness is consistent, although mental healthcare is not integrated into primary health care. Access to mental healthcare requires the involvement of affected communities in their problem-solving process. This review highlights the basis of the implementation of a comprehensive mental health care, through the application of mental health Gap Action Program (mhGAP) at community level. Lastly, it calls for further implementation research perspectives on the integration of mental healthcare into the health system of areas affecting by civil instability and natural disasters. Conclusion This paper acknowledges poor implementation of community mental health services into primary health care in regions affected by armed conflict and natural disasters. All relevant stakeholders involved in the provision of mental health services should need to rethink to implementation of mhGAP into the emergency response against outbreaks and natural disasters.
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Affiliation(s)
- Bives Mutume Nzanzu Vivalya
- Department of Psychiatry, Kampala International University Western Campus, P.O BOX 71, Bushenyi, Uganda. .,Department of Internal Medicine, Masereka General Referral Hospital, Goma, North-Kivu, Democratic Republic of the Congo.
| | | | | | | | - Augustin Kensale Kalume
- Department of Psychiatry, Kampala International University Western Campus, P.O BOX 71, Bushenyi, Uganda
| | - Astride Lina Piripiri
- Kinshasa School of Public Health, Faculty of Medicine University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Yvonne Duagani Masika
- Faculté de Psychologie et des Sciences de l'Education, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Jean-Bosco Kahindo Mbeva
- Department of Public Health, Official University of Ruwenzori, Goma, North-Kivu, Democratic Republic of the Congo
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