July 1985

Psychiatric DisordersA Rural/Urban Comparison

Author Affiliations

Ben Locke, MPH
From the Departments of Psychiatry (Drs Blazer, George, Landerman, Pennybacker, and Melville, and Ms Jordan) and Community and Family Medicine (Drs Woodbury and Manton), Duke University Medical Center, Durham, NC; and the Division of Biometry and Epidemiology, National Institute of Mental Health, Rockville, Md (Mr Locke).

Arch Gen Psychiatry. 1985;42(7):651-656. doi:10.1001/archpsyc.1985.01790300013002

• We studied rural/urban differences in the prevalence of nine psychiatric disorders from a community survey (part of the Epidemiologic Catchment Area Program) of 3,921 adults living in the Piedmont of North Carolina. Crude comparisons disclosed that major depressive episodes and drug abuse and/ or dependence were more common in the urban area, whereas alcohol abuse/dependence was more common in the rural area. When prevalence for these disorders was stratified for age, sex, race, and education (factors that may confound urban/rural comparisons), a number of significant differences were identified, such as higher prevalence of major depression in female and white subjects and higher prevalence of alcohol abuse/dependence in the less educated subjects. A logisticregression analysis was used to determine if significant urban/ rural differences persisted when these potential confounders were controlled. Major depressive disorders were found to be twice as frequent in the urban area in this controlled analysis.