Socio-economic factors that predict psychiatric admissions at a local level

Background. The aim of the study was to confirm the predictive relationship between socio-economic factors and psychiatric admissions at a fine grain geographical level. The strength of association was compared with those of other studies that have looked at separate diagnostic groups. Method. Psychiatric admissions were from electoral wards of the County of S outh Glamorgan, which encompasses the capital city of Wales, Cardiff. Stand ardized psychiatric admission ratios (SAR) for different diagnostic groups were calculated for a 5-year period. The ecological association with depriv ation indices and with single variables at the level of electoral ward was examined. Of a total of 15266 psychiatric admissions, 11296 were analysed. Results. Psychiatric morbidity, reflected in SAR was inversely related to s ocio-economic deprivation for both sexes. This applied to all diagnostic gr oups except organic disorders. The relationship was most marked for schizop hrenia, delusional disorders and substance abuse, closely followed by perso nality disorders, and less for affective and neurotic disorders. Little dif ference existed between three composite indices of deprivation (Carstairs, Jarman, Townsend), but the marginally best predictor was that designed by J arman. However, low rates of car ownership and high unemployment were as go od at predicting SAR as any of the compound indices. Conclusion. Socio-economic factors account for almost 50% of the variance i n psychiatric admission rates between electoral wards. The degree of associ ation between psychiatric morbidity and deprivation varies between diagnost ic groups, arguing against a common factor linking deprivation and psychiat ric admissions generally. Frequently updated unemployment figures provide n early as useful and more immediate information than 10-yearly Census data u sed to calculate the deprivation indices. These figures may be used for nee ds assessment and targeting resources at a local level.