The British Journal of Psychiatry (2009) 195: 156-162. doi: 10.1192/bjp.bp.108.051953
© 2009 The Royal College of Psychiatrists
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Urbanicity of place of birth and symptoms of psychosis, depression and anxiety in Uganda

Patric Lundberg, MD

Department of Health Sciences, Lund University, University Hospital UMAS, Malmö, Sweden, and Department of Public Health Sciences, Karolinska Institute, Norrbacka, Stockholm, Sweden

Elizabeth Cantor-Graae, PhD

Department of Health Sciences, Lund University, University Hospital UMAS, Malmö, Sweden

Godfrey Rukundo, MD and Schola Ashaba, MD

Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda

Per-Olof Östergren, MD, PhD

Department of Health Sciences, Lund University, University Hospital UMAS, Malmö, Sweden

Correspondence: Patric Lundberg, Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Norrbacka, 5th floor, S-171 76, Stockholm, Sweden. Email: patric.lundberg{at}ki.se

Declaration of interest

None.

Funding

The study was supported by the Swedish International Development Cooperation Agency (SIDA/SAREC) and the Medical Faculty at Lund University.

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.


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