DO SOCIOECONOMIC RISK-FACTORS PREDICT THE INCIDENCE AND MAINTENANCE OF PSYCHIATRIC-DISORDER IN PRIMARY-CARE

In a prospective cohort study of consecutive primary care attenders in south London, the estimated prevalence of non-psychotic psychiatric d isorder was 45.6%, using the Revised Clinical Interview Schedule (CIS- R). The estimated 12-month incidence rate was 15.7%. Extremely high st ability was found in CIS-R scores over 12 months (r = 0.65) and 68.8% of cases at baseline were also cases 12 months later. A clear differen ce emerged in the types of risk factor which were associated with the incidence and maintenance of disorder in the study population: while s ocioeconomic variables, especially low household income and not having a partner were associated with a worse outcome among prevalent cases at baseline, such variables were only weakly associated with the incid ence of psychiatric disorder after adjusting for potential confounders . The latter, notably family psychiatric history and the severity of p sychiatric symptoms at baseline were independently associated with the incidence of psychiatric disorder after adjusting for other risk fact ors, including measures of previous psychiatric disorder.