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

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.