Mental health disorders and associated factors among victims of gender-based violence at the Panzi One-Stop Center, in a context of conflict and limited resources in Eastern Democratic Republic of the Congo: A cross-sectional study

Background: Gender-based violence (GBV) is a serious public health problem with physical, social, and, above all, psychological repercussions for survivors. This study, which was conducted at the One Stop Center (OSC) at Panzi Hospital, aims to identify the determinants of mental health among GBV survivors. Methods: This cross-sectional study was carried out on a convenience sample of 932 survivors between April 2022 and March 2025. Mental health disorders were measured via the Hopkins Symptom Checklist (HSCL-25) for anxiety and depression (score ≥2.0) and the Harvard Trauma Questionnaire (HTQ) for PTSD (score ≥2). Sociodemographic data, characteristics of the attack, and physical and social consequences were studied. Multivariate analyses were performed with a significance threshold set at p < 0.05. Results: The prevalence ratesof mental health disorders among GBV survivors were 62.2% (95% CI: 59.1-65.2%) for anxiety, 53.7% (95% CI: 50.5-56.9%) for depression, and 36.5% (95% CI: 33.5-39.7%) for PTSD. The mean (SD) age of the survivors was 32.4 (14.1) years. Adults aged 18–49 years and those over 50 years were at greaterrisk of mental health problems. Being the head of the household also increased the risk of mental health problems. We also noted that forced marriage, being abused in the field/forest or in an unknown home, and the use of physical force and weapons increased the risk of anxiety, depression, and PTSD in survivors (p < 0.05). Unknown civilians, armed groups/rebels, the military, and multiple attacks increased the risk of anxiety, depression, and PTSD (p<0.05). Failure to seek medical attention within 72 hours increased the risk of depression. Having contracted a rape pregnancy, self-reported loss of hymen, and low back pain were associated with anxiety, depression, and PTSD (p<0.05). Dropping out of school and social rejection were associated with anxiety, depression, and PTSD (p<0.05). Conclusions: The prevalence of mental health problems remains high among GBV survivors followed at Panzi. Socioeconomicfactors and the severity of sexual assault are the main determinants. These results underscorethe need to strengthen early psychosocial care, community resilience programs, and sustainable socioeconomicsupport to mitigate the psychological impact of sexual violence in the context of conflict.