Background <p>Childhood trauma has a profound influence on the clinical manifestations of schizophrenia. This study aimed to explore the interrelationships among childhood trauma, psychiatric symptoms, neurocognition, and insomnia in Chinese patients with chronic schizophrenia using a network analysis approach.</p> Methods <p>A total of 649 patients with chronic schizophrenia were assessed using the Childhood Trauma Questionnaire–Short Form (CTQ-SF), Positive and Negative Syndrome Scale (PANSS), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and Insomnia Severity Index (ISI). Three networks were constructed and visualized. The expected influence (EI) and bridge expected influence (BEI) indices were calculated to identify central and bridge nodes.</p> Results <p>The prevalence of insomnia and childhood trauma was 18.3% (<i>n</i> = 119) and 49.5% (<i>n</i> = 321), respectively. Daytime dysfunction and distress caused by sleep problems showed the highest EI values and emerged as central nodes. The PANSS mood factor and difficulty falling asleep showed the highest BEI, indicating prominent cross-domain connectivity. Insomnia symptoms were strongly associated with the PANSS mood factor, particularly difficulty falling asleep. Neurocognitive performance, especially language ability, was primarily related to negative symptoms. Childhood trauma (CTQ-SF total score) was strongly associated with impaired quality of life and positive symptoms, with physical abuse showing the strongest correlation with the latter.</p> Conclusion <p>These findings underscore the clinical relevance of insomnia, affective symptoms, and childhood trauma—particularly physical abuse—in chronic schizophrenia and may help inform assessment priorities in future longitudinal and interventional studies.</p>