Mental health and urbanization An investigation of urban-rural and inner-city differences in psychiatric morbidity

A well-known review dating from the 1970s that looked at differences in the prevalence of psychiatric disorders between town and country showed that there was a tendency towards higher total rates of psychiatric disorders in urban areas. More specifically, rates for neurosis and personality disorders were higher in urban areas, while rates for psychoses, including manic-depressive psychoses, were higher in rural areas. Later reviews in the period 1981-1998 concluded that overall rates in urban areas were marginally higher and, specifically, that rates for depression were higher. In the last decade, there have been no systematic reviews of urban-rural differences in psychiatric morbidity. This thesis describes a recent international overview of studies of urban-rural differences in the prevalence of psychiatric disorders. It then bundles the prevalence rates from those studies, producing a single average ratio that expresses the urban-rural difference in the prevalence of psychiatric disorders (Chapter 4).