Prevalence of trauma-related psychological distress and associated factors among patients receiving neurological care in eastern Democratic Republic of the Congo: a cross-sectional study

Prolonged armed conflict in eastern Democratic Republic of the Congo (DRC) creates substantial psychological stress, yet evidence among patients receiving neurological care remains limited. We estimated the prevalence of positive Trauma Screening Questionnaire (TSQ) screening and examined associated sociodemographic, clinical, and contextual factors. A hospital-based cross-sectional survey was conducted at CIMAK in Goma from December 2024 to March 2025. Adults with a current clinician-confirmed neurological disorder were systematically sampled. The 10-item TSQ was scored from 0 to 10; scores ≥ 6 defined a positive screening result, not a psychiatric diagnosis. Explanatory multivariable logistic regression was used. Because age showed a nonlinear relationship with the log-odds of positive screening, age was modeled in categories. Among 569 participants, 324 (56.9%) screened positive; 301 (52.9%) were female, 440 (77.3%) lived in urban areas, and mean age was 40.5 ± 19.8 years. Conflict-related trauma exposure was strongly associated with positive screening (aOR 12.60, 95% CI 7.96–19.94; p < 0.001), as was substance use (aOR 2.28, 95% CI 1.42–3.66; p < 0.001). Compared with participants aged 18–29 years, those aged 30–44 years (aOR 2.81, 95% CI 1.54–5.14) and 45–59 years (aOR 3.67, 95% CI 1.81–7.41) had higher odds; the ≥ 60-year group did not differ significantly. Male sex and urban residence were associated with lower odds. History of traumatic brain injury did not remain statistically significant after adjustment. Positive TSQ screening was common among adults receiving neurological care in this conflict-affected setting. The findings support trauma-informed psychological screening and referral within neurological services while emphasizing that cross-sectional screening results are neither causal estimates nor psychiatric diagnoses.