Correlates of adverse childhood experiences among admitted patients with schizophrenia in a referral psychiatric hospital in Botswana

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Introduction: Schizophrenia is becoming more prevalent globally, particularly in lower and middle-income countries. Adverse childhood experiences (ACEs) are significant risk factors for developing and worsening the disorder. This study aimed to determine the pattern and correlates of ACE among inpatients with Schizophrenia at Sbrana Psychiatric Hospital in Botswana. Methods: In a cross-sectional cohort study, 128 adult patients diagnosed with Schizophrenia were sampled over a 6-month period. The Adverse Childhood Experiences International Questionnaire (ACE-IQ) and the Positive and Negative Syndrome Scale (PANSS) were used to study ACEs and assess schizophrenia severity. A regression model was used to determine factors that predicted the severity and frequency of admissions, with a significance level set at p ⩽ .05. Results: Participants were mostly males (78.9%), with a mean age of 36.7 ( SD = 11.01). About 93.8% reported at least 1 ACE, and 56.3% had ⩾4 ACEs. There was a positive correlation between the number of ACEs and positive symptoms ( r s = .24, p < .01) and the general psychopathology score ( r s = .18, p < .05). Having an incarcerated household member (AOR = 2.43; 95% CI [1.02, 5.81]) was associated with PANSS >75. Participants who had experienced physical abuse were more likely to have multiple admissions (AOR = 5.88; 95% 95% CI [1.87, 18.51]). Conclusion: Our findings highlight the high prevalence of multiple ACEs among patients with Schizophrenia. More interventions are therefore needed to mitigate the risk of ACEs.

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