Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 40, Issue 8, pp 613–618 | Cite as

Mood disorders and urban/rural settings

Comparisons between two French regions
  • Viviane Kovess-MasfetyEmail author
  • Xavier Lecoutour
  • Stéphane Delavelle
Original Paper

Abstract

Background

A review of the main large-scale mental health surveys does not give full support to the idea of urbanicity as a risk factor in mood disorders. Lack of agreement between findings can be attributed, at least in part, to heterogeneous operationalisation of urbanicity, as different ways to define urban and rural areas are likely to lead to different morbidity rates and to have an effect on the respective weight of other risk factors.

Methods

A total of 2,638 subjects sampled from two French regions (Basse-Normandie and Ile-de-France) were interviewed using face-to-face parts of the Composite International Diagnostic Interview covering demographic and certain life event questions. Urbanicity was defined according to (1) official index based on population density or (2) type of dwelling. Participation rates were 85 and 79%.

Results

When gender, age, marital status and certain early life events, such as being placed in an institution, as well as events concerning close family members are entered into a logistic regression, the urbanicity association with DSM-IV MDE and especially severe forms disappeared. This finding tends to support the theory that what happens to individuals is more relevant to depression than the place where they live.

Conclusion

It may be wiser to rely on social indicators than on a rural/urban component for planning for mental health care in the various areas; this remark should not prevent to evaluate the topographic situations of the diverse settings to take them into account to provide appropriate resources.

Keywords

rural urban survey mental health planning health care 

Notes

Acknowledgements

The Parisian area study was funded by the City of Paris (DASES), the French Ministries of Health, Environment and Defense and the Avenir Foundation. The Basse-Normandie study was made possible through funding by the Regional Councils of Basse-Normandie, Calvados, Manche and Orne, Lilly France Health Economics Department and AXA Insurance Normandie-Maine.

References

  1. 1.
    Andrews G, Henderson S, Hall W (2001) Prevalence, comorbidity, disability and service utilisation. Overview of the Australian National Mental Health Survey. Br J Psychiatry 178:145–153CrossRefPubMedGoogle Scholar
  2. 2.
    Bijl RV, Ravelli A, van Zessen G (1998) Prevalence of psychiatric disorders in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 33:587–595CrossRefPubMedGoogle Scholar
  3. 3.
    Blazer D, George LK, Landerman R, Pennybacker M, Melville ML, Woodbury M, Manton KG, Jordan K, Locke B (1985) Psychiatric disorders. A rural/urban comparison. Arch Gen Psychiatry 42:651–656PubMedGoogle Scholar
  4. 4.
    Brown GW, Prudo R (1981) Psychiatric disorders in a rural and an urban population: 1. Aetiology of depression. Psychol Med 11:581–599PubMedGoogle Scholar
  5. 5.
    Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19PubMedGoogle Scholar
  6. 6.
    Kovess V, Murphy HB, Tousignant M (1987) Urban–rural comparisons of depressive disorders in French Canada. J Nerv Ment Dis 175:457–466PubMedGoogle Scholar
  7. 7.
    Kovess V, Gysens S, Poinsard R, Chanoit PF, Labarte S (1999) Mental health and use of care by people receiving French social benefits. Soc Psychiatry Psychiatr Epidemiol 34:588–594CrossRefPubMedGoogle Scholar
  8. 8.
    Kovess V, Fournier L, Lesage AD, Lebigre FA, Caria A (2001) Two validation studies of the CIDIS: a simplified version of the composite international diagnostic interview. Psychiatr Netw 4:10–24Google Scholar
  9. 9.
    Kovess V, Labarte S, Chanoit PF (2002) La santé mentale en région Ile de France: des données épidémiologiques à la planification [Mental health in the Ile-de-France region: from epidemiological data to forward planning]. Inf Psychiatr 1:43–55Google Scholar
  10. 10.
    Lewis G, Booth M (1994) Are cities bad for your mental health? Psychol Med 24:913–915PubMedGoogle Scholar
  11. 11.
    Parikh SV, Wasylenki D, Goering P, Wong J (1996) Mood disorders: rural/urban differences in prevalence, health care utilization, and disability in Ontario. J Affect Disord 38:57–65CrossRefPubMedGoogle Scholar
  12. 12.
    Paykel ES, Abbott R, Jenkins R, Brugha TS, Meltzer H (2000) Urban–rural mental health differences in Great Britain: findings from the National Morbidity Survey. Psychol Med 30:269–280CrossRefPubMedGoogle Scholar
  13. 13.
    Prudo R, Brown GW, Harris T, Dowland J (1981) Psychiatric disorders in a rural and an urban population: 2. Sensitivity to loss. Psychol Med 11:601–616PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Viviane Kovess-Masfety
    • 1
    Email author
  • Xavier Lecoutour
    • 2
  • Stéphane Delavelle
    • 3
  1. 1.MGEN Foundation for Public HealthUniversity of Paris VParisFrance
  2. 2.University of CaenCaenFrance
  3. 3.INSEEBasse NormandieFrance

Personalised recommendations