Psychol Med. 2019 Aug 7:1-8. doi: 10.1017/S0033291719001703. [Epub ahead of print]
The relationship between childhood trauma and schizophrenia in the Genomics of Schizophrenia in the Xhosa people (SAX) study in South Africa.

Mall S1, Platt JM2, Temmingh H1, Musenge E3, Campbell M1, Susser E2, Stein DJ1.
Author information
1. Department of Psychiatry and Mental Health,Faculty of Health Sciences,University of Cape Town,Cape Town,South Africa.
2. Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,USA.
3. Division of Epidemiology and Biostatistics,School of Public Health,Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa.

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–control; South Africa; childhood trauma; psychosis