The influence of social deprivation as measured by the CNI on psychiatric admissions

The purpose of this study was to examine the importance of social deprivati on for psychiatric admissions and its correlation with two different depriv ation scores. Care Need Index (CNI) and Townsend scores were calculated at the small area level in Malmo, a city in southern Sweden. Admission rates f or all psychiatric inpatients from Malmo aged 20-79 years, admitted to the psychiatric and alcohol clinics from 1 January 1991 to 31 December 1994, we re calculated. The relationship between the CNI and psychiatric admissions was analysed by applying a Poisson regression model. The results are shown as incidence density ratios (IDR) with 95% confidence intervals (CI). From the most deprived areas, the first psychiatric admission rate was more than four times higher than in the most affluent areas. The rates of second and third admission were even higher. Admissions to the alcohol clinic were si milar to psychiatric admissions, but the most deprived areas had first admi ssion rates about ten times higher than in the most affluent areas. About 2 7% of first admissions, including patients from both psychiatric and alcoho l clinics, had a diagnosis of psychosis, and 43% were substance abusers. Th ere were differences between the patients' diagnoses in different areas. Th e correlation between the CNI and Townsend scores was very high. The most i mportant finding of this study is the strong correlation between social dep rivation, based on different deprivation indices, and first admissions to p sychiatric and alcohol clinics.