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Psychiatric Disorders:  A Rural/Urban Comparison

Dan Blazer, MD, PhD; Linda K. George, PhD; Richard Landerman, PhD; Margaret Pennybacker, PhD; Mary Lou Melville, MD; Max Woodbury, PhD, MPH; Kenneth G. Manton, PhD; Kathleen Jordan, MA
Arch Gen Psychiatry. 1985;42(7):651-656. doi:10.1001/archpsyc.1985.01790300013002.
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• 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.

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