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The relationship between childhood trauma and schizophrenia in the Genomics of Schizophrenia in the Xhosa people (SAX) study in South Africa

Published online by Cambridge University Press:  07 August 2019

Sumaya Mall ,
Jonathan M. Platt ,
Henk Temmingh ,
Eustasius Musenge ,
Megan Campbell ,
Ezra Susser  and
Dan J. Stein
Sumaya Mall*
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Jonathan M. Platt
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
Henk Temmingh
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Eustasius Musenge
Affiliation:
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Megan Campbell
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Ezra Susser
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA New York State Psychiatric Institute, New York, USA
Dan J. Stein
Affiliation:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa SU/UCT Medical Research Council Unit on Risk & Resilience in Mental Disorders, South Africa
*
Author for correspondence: Sumaya Mall, E-mail: [email protected]
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Abstract

Background

Evidence from high-income countries suggests that childhood trauma is associated with schizophrenia. Studies of childhood trauma and schizophrenia in low and middle income (LMIC) countries are limited. This study examined the prevalence of childhood traumatic experiences among cases and controls and the relationship between specific and cumulative childhood traumatic experiences and schizophrenia in a sample in South Africa.

Methods

Data were from the Genomics of Schizophrenia in the South African Xhosa people study. Cases with schizophrenia and matched controls were recruited from provincial hospitals and clinics in the Western and Eastern Cape regions in South Africa. Childhood traumatic experiences were measured using the Childhood Trauma Questionnaire (CTQ). Adjusted logistic regression models estimated associations between individual and cumulative childhood traumatic experiences and schizophrenia.

Results

Traumatic experiences were more prevalent among cases than controls. The odds of schizophrenia were 2.44 times higher among those who experienced any trauma than those who reported no traumatic experiences (95% CI 1.77–3.37). The odds of schizophrenia were elevated among those who experienced physical/emotional abuse (OR 1.59, CI 1.28–1.97), neglect (OR 1.39, CI 1.16–1.68), and sexual abuse (OR 1.22, CI 1.03–1.45) compared to those who did not. Cumulative physical/emotional abuse and neglect experiences increased the odds of schizophrenia as a dose–response relationship.

Conclusion

Childhood trauma is common in this population. Among many other benefits, interventions to prevent childhood trauma may contribute to a decreasing occurrence of schizophrenia.

Keywords

Case–controlchildhood traumapsychosisSouth Africa
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 9 , July 2020 , pp. 1570 - 1577
Copyright
Copyright © Cambridge University Press 2019

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