Regional differences in mental health in Great Britain.

STUDY OBJECTIVE--The aim was to study the pattern and magnitude of regional differences in psychiatric morbidity and compare these with regional differences in all cause mortality. DESIGN--The study was a secondary analysis of data from a cross sectional survey. The main outcome was the prevalence of psychiatric morbidity. This was assessed using the general health questionnaire, a self administered measure of neurotic symptoms. SETTING--England, Wales and Scotland. PARTICIPANTS--9003 adults were selected from the electoral register. MAIN RESULTS--The prevalence of psychiatric morbidity was 31% with a statistically significant difference between the regions (p = 0.006). All four northern regions of England had a higher prevalence of psychiatric morbidity than the four southern regions. These differences were comparable in size to the regional differences in all cause mortality. Scotland had low psychiatric morbidity but high all cause mortality while Greater London had high psychiatric morbidity but low mortality. Regional variation in psychiatric morbidity was less marked within social classes I and II and among those living in urban areas. CONCLUSIONS--Psychiatric morbidity is common and is an important public health problem. Regions with relatively high psychiatric morbidity did not always have relatively high mortality. Knowledge of the causes of these regional differences could ultimately lead to preventive action and be important when distributing health service resources.