Logie Carmen H.Okumu MosesMwima SimonHakiza RobertChemutai DoreenKyambadde Peter2026-09-222026-09-222020-05-15https://doi.org/10.1186/s13031-020-00289-7http://hdl.handle.net/20.500.14270/941The datasets generated and/or analysed during the current study are not publicly available due to research ethics board restrictions but are available from the corresponding author on reasonable request and on attaining research ethics board amendments from the University of Toronto and Uganda Ministry of Health. The study received ethical approval from the University of Toronto, Canada and the Ugandan Ministry of Health. We also received permission from Office of the Prime Minister. All participants provided informed consent to participate in the studyBackground: Advancing mental health among refugee and displaced adolescents and youth is critically important, as chronic psychological stress can have lifelong harmful impacts. These groups experience socio-environmental stressors that can harm mental health. Informed by a social contextual framework, this study explored the prevalence of depression among urban refugee and displaced youth in Kampala, Uganda and associations with symbolic (violence), relational (social support), and material (food and community insecurity) contexts. Methods: We implemented a cross-sectional survey with refugee and displaced adolescent girls and young women and adolescent boys and young men aged 16–24 living in Kampala’s informal settlements. We conducted peer-driven recruitment, whereby peer navigators shared study information with their networks and in turn participants were invited to recruit their peers. We conducted gender disaggregated analyses, including stepwise multiple regression to examine factors associated with depression. We then conducted structural equation modeling (SEM) using weighted least squares estimation to examine direct paths from violence, food insecurity, and community insecurity to depression, and indirect effects through social support. Results: Among participants (n = 445), young women (n = 333) reported significantly higher depression symptoms than young men (n = 112), including any symptoms (73.9% vs. 49.1%, p < 0.0001), mild to moderate symptoms (60.4% vs. 45.5%, p = 0.008), and severe symptoms (13.5% vs 3.6%, p = 0.002). SEM results among young women indicate that the latent violence factor (lifetime sexual and physical violence) had direct effects on depression and social support, but social support did not mediate the path from violence to depression. The model fit the data well: χ2(3) = 9.82, p = 0.020; RMSEA = 0.08, 90% CI [0.03, 0.14], CFI = 0.96). Among young men, SEM findings indicate that food insecurity had direct effects on social support, and an indirect effect on depression through the mediating role of social support. Fit indices suggest good model fit: χ2(3) = 2.09, p = 0.352; RMSEA = 0.02, 90% CI [0.000, 0.19], CFI = 0.99.enDepressionYouthUgandaRefugeesPovertyViolenceSocial supportFood insecurityCommunity insecurityContextArticle