Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey

Background. Studies of urban-rural differences in prevalence of non-psychot ic mental disorder have not given consistent findings. Such differences hav e received relatively little study in Great Britain. Methods. Data from 9777 subjects in the Household Survey of the National Mo rbidity Survey of Great Britain were analysed for differences between urban , semi-rural and rural areas. Psychiatric morbidity was assessed by scores on the Revised Clinical Interview Schedule (CIS-R), together with alcohol d ependence, drug dependence, receipt of treatment from general practitioners . Associations with other characteristics were examined by logistic regress ion. Results. Urban subjects had higher rates than rural of CIS-R morbidity, alc ohol dependence and drug dependence, with semi-rural subjects intermediate. Urban subjects also tended to be members of more deprived social groups, w ith more adverse living circumstances and greater life stress, factors them selves associated with disorder. Urban-rural differences in alcohol and dru g dependence were no longer significant after adjustment for these factors by logistic regression, and differences on CIS-R morbidity were considerabl y reduced. There were no differences in reatment. Conclusions. There are considerable British urban-rural differences in ment al health, which may largely be attributable to more adverse urban social e nvironments.