Admassu Zerihun, Chen Sikky Shiqi, Logie Carmen H, Okumu Moses, MacKenzie Frannie, Hakiza Robert, Musoke Daniel Kibuuka, Katisi Brenda, Nakitende Aidah, Kyambadde Peter, Mbuagbaw Lawrence
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
United Nations University Institute for Water, Environment, and Health, Hamilton, ON, Canada.
Glob Ment Health (Camb). 2024 Dec 16;11:e125. doi: 10.1017/gmh.2024.135. eCollection 2024.
There is a high prevalence of depression among refugee youth in low- and middle-income countries, yet depression trajectories are understudied. This study examined depression trajectories, and factors associated with trajectories, among urban refugee youth in Kampala, Uganda.
We conducted a longitudinal cohort study with refugee youth aged 16-24 in Kampala, Uganda. We assessed depression using the Patient Health Questionnaire-9 and conducted latent class growth analysis (LCGA) to identify depression trajectories. Sociodemographic and socioecological factors were examined as predictors of trajectory clusters using multivariable logistic regression.
Data were collected from n = 164 participants (n = 89 cisgender women, n = 73 cisgender men, n = 2 transgender persons; mean age: 19.9, standard deviation: 2.5 at seven timepoints; n = 1,116 observations). Two distinct trajectory clusters were identified: "sustained low depression level" (n = 803, 71.9%) and "sustained high depression level" (n = 313, 28.1%). Sociodemographic (older age, gender [cisgender women vs. cisgender men], longer time in Uganda), and socioecological (structural: unemployment, food insecurity; interpersonal: parenthood, recent intimate partner violence) factors were significantly associated with the sustained high trajectory of depression.
The chronicity of depression highlights the critical need for early depression screening with urban refugee youth in Kampala. Addressing multilevel depression drivers prompts age and gender-tailored strategies and considering social determinants of health.
在低收入和中等收入国家的难民青年中，抑郁症的患病率很高，但对抑郁症的发展轨迹研究不足。本研究调查了乌干达坎帕拉城市难民青年的抑郁症发展轨迹及其相关因素。
我们在乌干达坎帕拉对16 - 24岁的难民青年进行了一项纵向队列研究。我们使用患者健康问卷-9评估抑郁症，并进行潜在类别增长分析（LCGA）以确定抑郁症发展轨迹。使用多变量逻辑回归分析社会人口学和社会生态因素作为轨迹集群的预测因素。
收集了n = 164名参与者的数据（n = 89名顺性别女性，n = 73名顺性别男性，n = 2名跨性别者；平均年龄：19.9岁，标准差：2.5岁；在七个时间点进行了n = 1,116次观察）。确定了两个不同的轨迹集群：“持续低抑郁水平”（n = 803，71.9%）和“持续高抑郁水平”（n = 313，28.1%）。社会人口学因素（年龄较大、性别[顺性别女性与顺性别男性]、在乌干达的时间较长）以及社会生态因素（结构因素：失业、粮食不安全；人际因素：为人父母、近期亲密伴侣暴力）与抑郁症的持续高轨迹显著相关。
抑郁症的慢性特征凸显了在坎帕拉对城市难民青年进行早期抑郁症筛查的迫切需求。解决多层次的抑郁症驱动因素需要制定针对年龄和性别的策略，并考虑健康的社会决定因素。
