Is the prevalence of psychiatric disorders associated with urbanization?

Abstract

j Abstract Objectives In many countries, the total rate of psychiatric disorders tends to be higher in urban areas than in rural areas. The relevance of this phenomenon is that it may help in identifying environmental factors that are important in the pathogenesis of mental disorders. Moreover, urban preponderance suggests that the allocation of funds and services should take urbanization levels into account. Method The Netherlands Mental Health Survey and Incidence Study (NEMESIS) used the Composite International Diagnostic Interview (CIDI) to determine the prevalence of DSM-III-R disorders in a sample of 7,076 people aged 18-64. The sample was representative of the population as a whole. The study population was assigned to five urbanization categories defined at the level of municipalities. The association between urbanization and 12-month prevalence rates of psychiatric disorders was studied using logistic regression taking several confounders into account. Results The prevalence of psychiatric disorders gradually increased over five levels of urbanization. This pattern remained after adjustment for a range of confounders. Comorbidity rates also increased with level of urbanization. Conclusion This study confirms that psychiatric disorders are more common and more complex in more urbanized areas. This should be reflected in service allocation and may help in identifying environmental factors of importance for the aetiology of mental disorders.

Prevalence of Common Mental Disorders among Incident Individuals on Long-Term Sickness Absence When Compensating for Non-Participation

“…The higher frequency of mental disorders for the female gender than for male gender shown in this study is in accordance with consistent findings from population samples for affective disorders and anxiety (Alonso et al, 2004;Bijl et al, 1998;Lindeman et al, 2000;Hodiamont et al, 1987;Offord et al, 1996;Bijl et al, 2002;Peen et al, 2007;Jenkins et al, 1997;Bebbington et al, 2003;Akhtar-Danesh & Landeen, 2007;Kessler et al, 1994). The opposite for alcohol and drug dependence was also in agreement with other studies.…”

“…The high frequency of mental disorders for individuals aged below 40 years as well as the trend of decreasing frequencies of mental disorders with older age as found in this study was also in accordance with the majority of other studies (Alonso et al, 2004;Bijl et al, 1998;Lindeman et al, 2000;Offord et al, 1996;Bijl et al, 2002;Bebbington et al, 2003;Akhtar-Danesh & Landeen, 2007;Kessler et al, 1994). Several population studies have shown higher frequencies of mental disorders with increasing urbanity (Bijl et al, 1998;Hodiamont et al, 1987;Peen et al, 2007;Jenkins et al, 1997). This trend was verified in the present study as well.…”

“…The opposite for alcohol and drug dependence was also in agreement with other studies. (Alonso et al, 2004;Bijl et al, 1998;Lindeman et al, 2000;Hodiamont et al, 1987;Offord et al, 1996;Bijl et al, 2002;Peen et al, 2007;Jenkins et al, 1997;Bebbington et al, 2003;Akhtar-Danesh & Landeen, 2007;Kessler et al, 1994). The high frequency of mental disorders for individuals aged below 40 years as well as the trend of decreasing frequencies of mental disorders with older age as found in this study was also in accordance with the majority of other studies (Alonso et al, 2004;Bijl et al, 1998;Lindeman et al, 2000;Offord et al, 1996;Bijl et al, 2002;Bebbington et al, 2003;Akhtar-Danesh & Landeen, 2007;Kessler et al, 1994).…”

Travel Distance and the Use of Inpatient Care among Patients with Schizophrenia

“…Due to difficulties finding providers, many patients in rural areas may resist seeing a doctor until they are severely sick (Goldsmith et al 1997), even though a lower prevalence and incidence of psychiatric disorders are noted in rural versus urban areas (Peen et al 2007). Rural residency, therefore, influences the use of psychiatric care through its contextual effects on the occurrence and severity of psychiatric illness.…”

Factors Associated with Positive Mental Health in a Portuguese Community Sample: A Look Through the Lens of Ryff's Psychological Well-Being Model

“…Given the scarce body of literature on this subject, such results need to be interpreted with caution, without neglecting the possible indirect effects of variables such as educational attainment, occupational status, income, access to health services, among others. Several studies have identified rural-urban disparities in psychiatric disorders and quality of life (Peen et al, 2007(Peen et al, , 2010. Among a Portuguese adolescent sample, Fernandes and Vasconcelos-Raposo (2008) found that urban residents reported higher scores for personal growth, purpose in life, self-acceptance and total well-being.…”