The 800 census enumeration districts of Nottingham were used as a basis for the production of 12 distinct 'clusters' or neighbourhood types. Plotting the place of residence of the 68 patients with 'certain' or 'very likely' diagnoses of ICD-9 schizophrenia, identified in the World Health Organization Study of Determinants of Outcome of Severe Mental Disorders, showed the expected concentration in central areas of low social status. A more varied distribution was found for 132 patients with a case-register diagnosis of affective psychosis, contacting the psychiatric services for the first time during the same two-year period as the schizophrenic patients. Some of the highest rates for affective psychosis were found in new housing estates of middle and low status at some distance from the town centre.
The lifetime geographical mobility of a group of 67 patients suffering from schizophrenia was investigated and related to the ecological structure of the city of Nottingham, where they first presented between 1978 and 1980. The study aimed to investigate the processes leading to a threefold rate of schizophrenia in the most socioeconomically deprived area of the city compared to the area of least deprivation. Results suggest that this skewed distribution begins early in the lives of the patients and is well established at least five years before initial contact with the psychiatric services.
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