Urban ecology of mental disorders - Conclusions from six decades of ecological research in psychiatry

In 1939, Robert Faris and Warren Dunham published their pioneering work on "Mental disorders in urban areas". They investigated the distribution of me ntal disorders in Chicago. In the following decades, a number of studies us ing a similar design were carried out in various cities in the United State s and in Europe, which largely replicated Faris' and Dunham's findings. The concentration of most psychiatric disorders in certain problem areas indic ates the existence of a relationship between their distribution and unfavor able social conditions. However, the intention of ecological studies to fin d strong evidence for the psyche-social cause of mental disorders, especial ly of schizophrenia, failed. In schizophrenia, social selection leading to a particular spatial distribution of schizophrenic patients as a consequenc e of their illness or premorbid condition seems to be the most important fa ctor. Rather than malting a substantial contribution to the search for the causes of mental disorders as has been assumed up to now, identifying high risk areas of psychiatric disorders may serve as a rational basis for servi ce planning and the allocation of resources.