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Geographical variation in rates of common mental disorders in Britain: prospective cohort study

Division of Health in the Community, Warwick Medical School (LWMS), University of Warwick

LIZ TWIGG, PhD

Institute for the Geography of Health, Department of Geography, University of Portsmouth

GLYN LEWIS, PhD

Division of Psychiatry, University of Bristol

KELVYN JONES, PhD

School of Geographical Sciences, University of Bristol

Correspondence: Scott Weich, Division of Health in the Community, Warwick Medical School (LWMS), University of Warwick, Coventry CV4 7AL, UK. Tel: +44 (0)2476 574708; e-mail: s.weich{at}warwick.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background There is little geographical variation in the prevalence of the common mental disorders. However, there is little longitudinal research.

Aims To estimate variance in rates of common mental disorders at individual, household and electoral ward levels prospectively.

Method A 12-month cohort study of 7659 adults aged 16-74 years in 4338 private households, in 626 electoral wards. Data were collected as part of the British Household Panel Survey. Common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ). Ward-level socio-economic deprivation was measured using the Carstairs index.

Results Less than 1% of total variance, in onset and maintenance of common mental disorders and change in GHQ score between waves, occurred at ward level. However, 12% of variance, which is a statistically significant difference, was found at household level (a much smaller geographical unit) and this difference remained after further analyses.

Conclusions Ward level socio-economic deprivation does not influence the onset and maintenance of common mental disorders in Britain but local factors at the household level do. Reasons for this remain unclear.

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