Variations in responses to a symptom check-list by age, sex, income, residence and ethnicity

Two rural, two outer- and two innercity population samples totaling 875 subjects were surveyed with the Langner symptom check-list and the results analysed by sex, age, income, residence and ethnicity. Women's scores exceeded those of men in all samples, but more so in the rural than in the urban groups. Age did not correlate with score in any sample and income level was related to scores in the expected way within each residential zone. The main finding, however, was that the outer city sample scored substantially higher than the others even when allowance was made for income level. — Factor analysis and examination of the results item by item showed that three weak symptom clusters existed. A ‘depressive’ cluster was particularly revealed by the outer city dwellers and by the Anglo-Canadians, but rarely mentioned by the rural sample which was French-Canadian. A ‘psychosomatic’ cluster was most often mentioned by the inner- and outer-city French-Canadians and relatively rarely by the rural sample and by the Anglo-Canadians. The third cluster, ‘anxiety’, was comparatively frequently mentioned by all samples but less so by men than by women. In all samples, regardless of whether a French or an English version of the scale was used, certain items tended to receive the most positive answers while certain other items were rarely answered positively by anyone. — Various explanations are discussed for the higher rates among outer city dwellers, but in view of the fact that the latter seem to be less under objective strain and less prone to major mental disorders than some of the other samples, it is considered that such check-lists should not be employed as the main tool for estimating the comparative mental health or stress situation of a population until further research is done on the subject.