Nithsdale, Nunhead and Norwood: similarities and differences in prevalence of schizophrenia and utilisation of services in rural and urban areas.
BACKGROUND
The prevalence of schizophrenia is known to be greater in urban than in rural areas. Less studied are differences between the patients themselves and, more specifically, their use of psychiatric services.


METHODS
The prevalence of schizophrenia was determined in rural Nithsdale in Scotland and urban Nunhead and Norwood in South London. Information about patients' psychiatric history, use of services during the study year and global assessment of functioning were obtained from case records and staff.


RESULTS
There were no significant differences in prevalence rates between Nithsdale patients, all White (2.78 per 1000 general population), Nunhead (3.46 per 1000) and Norwood (2.24 per 1000) Whites; rates were significantly higher among the non-Whites in Nunhead (7.36 per 1000) and Norwood (5.53 per 1000), who were mainly Black Caribbeans. Nithsdale patients were at a higher level of functioning and made substantially more use of psychiatric services. During the study year, 42% of Nithsdale patients used more than one of three principal community services, namely day, out-patient and community psychiatric nursing care.


CONCLUSIONS
The prevalence of schizophrenia is no different in rural Nithsdale and inner-city Nunhead and Norwood, when only White patients are considered. Nithsdale patients were at a higher level of functioning and made more use of available psychiatric services.
McCreadie
R G
RG
Department of Clinical Research, Crichson Royal Hospital, Dumfries.
Leese
M
M
Tilak-Singh
D
D
Loftus
L
L
MacEwan
T
T
Thornicroft
G
G
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D019037:Urban Health Services / Q000706:statistics & numerical data*; D014900:West Indies / Q000208:ethnology