Objective The aim of this study was to identify the effects of severe wildfires on the population’s mental health in the long term and the role of perceived health status, health vulnerability, resiliency and sense of coherence.

Methods A longitudinal survey with 3 waves (9, 19 and 24 months after the wildfire) was carried out in a representative sample of the municipalities’population affected by the 2017 severe wildfires in the central region of Portugal with data collection by questionnaire on CAPI mode. PHQ 8 (major depressive disorder-MDD), sense of coherence (SOC) and resiliency (CD-RISC) scales were included along with 4 questions related to perceived health status and demographic variables. Statistical analysis was performed using generalized estimating equations approach.

Results 312 individuals (95% of the sample) participated in the set of the 3 waves. The prevalence of MDD was higher than the overall value of the country (9.1%) and of the region (9.75%) with higher values in the 1st and 3rd waves (21% and 20%, respectively) and a decrease in the 2nd wave (11.6%). No significant relation between resiliency and MDD over time was observed, but SOC, perceived health status and the expected health worsening showed a negative relation with MDD, except for individual disease vulnerability.

Conclusion The higher prevalence of MDD 24 months after wildfires exposure is a great concern. The influence over time of perceived health status and expected health worsening points to the need for a more integrated approach of mental and GP care. The SOC influence shows that participants still have personal resources to face adversity but personal disease vulnerability along with the lack of resiliency effect suggests a low adaptation ability in this population that should be enhanced.