Urbanicity of place of birth and symptoms of psychosis, depression and anxiety in Uganda

Abstract

Background: The mechanism underlying the association between urban birth/upbringing and increased schizophrenia risk is unknown. This study explored whether an urban effect might be present in a low-income country setting, where the ‘urban’ environment may have radically different components, for example urban architecture, pollution levels or social cohesion. Aims: To investigate the potential association of urbanicity of place of birth and symptoms of psychosis, depression and anxiety in Uganda. Method: Ugandans aged 18–30 years (n = 646) were interviewed using the Peters et al Delusions Inventory (PDI–21), the Hopkins Symptoms Checklist (HSCL–25) and psychoticism items from the Symptoms Checklist 90-items version (SCL–90) in Mbarara and Kampala districts and asked about their birthplace. Results: Urban birth (but not semi-urban) was associated with more lifetime psychotic experiences, especially grandiosity, and more symptoms of psychosis, depression and anxiety during the past week. Conclusions: The urban risk factor for schizophrenia may be universally present across different levels of human development, albeit the nature of the mechanism remains elusive.