Prevalence and associated factors of common mental disorders among internally displaced people by armed conflict in Cabo Delgado, Mozambique: a cross-sectional community-based study

Naisa Manafe, Hamida Ismael-Mulungo, Fábio Ponda, Palmira F. Dos Santos, Flávio Mandlate, Vasco F. J. Cumbe, Ana Olga Mocumbi, and Maria R. Oliveira Martins

Frontiers in Public Health, Volume 12 (2024)


This study estimates the prevalence of post-traumatic stress disorder (PTSD), depression, and anxiety, and associated factors among armed conflict survivors in Cabo Delgado, in northern Mozambique. Mozambique hosts nearly 32,000 refugees and asylum-seekers, and more than one million IDPs displaced by violence perpetrated by non-state armed groups.

Data was collected through face-to-face interviews with 748 participants using a structured questionnaire between January and April 2023. Information was collected on sociodemographic characteristics, health conditions, missing family members, death of family and friends, and exposure to armed conflict. PTSD, anxiety, and depression were evaluated using the Primary Care Post-Traumatic Stress Disorder Checklist (PC-PTSD-5), the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire – Mozambique (PHQ-9 MZ), respectively.

Main results:

  • There were high rates of PTSD, depression and anxiety found in the sample. An estimated 74 percent of participants had PTSD, 64 percent had depression, and 40 percent had anxiety.
  • PTSD is associated with depression, anxiety, and suicide ideation. PTSD was found in 90 percent and 89 percent of patients with depression, and anxiety symptoms, respectively. Having depressive symptoms, anxiety symptoms and suicide ideation were significantly associated with PTSD.
  • The likelihood of developing PTSD was higher in females, in individuals with longer exposure to armed conflict, and in individuals having a family member or close friend injured or killed. Females had 2.2 times the likelihood of developing PTSD than males. The likelihood of developing PTSD was 4.8 times higher among individuals who had been exposed to war between 12 weeks to a year compared to those who had been exposed to war for 11 weeks or less.

The prevalence of depression, anxiety, and PTSD was high compared with similar studies conducted elsewhere. The authors recommend a scale-up of mental health care, by increasing medical workers’ capacity to diagnose and treat patients with mental health disorders.