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A three-year follow-up of psychiatric morbidity in urban and rural primary care

Published online by Cambridge University Press:  09 July 2009

Helen Seivewright ,
Peter Tyrer ,
Patricia Casey  and
Nicholas Seivewright
Helen Seivewright
Affiliation:
Fosse Medical Centre, Leicester; St Charles' Hospital, London; Professorial Psychiatric Unit, Mater Misericordiae Hospital, Dublin, Ireland; Regional Drug Dependence Unit, Prestwich Hospital, Manchester
Peter Tyrer*
Affiliation:
Fosse Medical Centre, Leicester; St Charles' Hospital, London; Professorial Psychiatric Unit, Mater Misericordiae Hospital, Dublin, Ireland; Regional Drug Dependence Unit, Prestwich Hospital, Manchester
Patricia Casey
Affiliation:
Fosse Medical Centre, Leicester; St Charles' Hospital, London; Professorial Psychiatric Unit, Mater Misericordiae Hospital, Dublin, Ireland; Regional Drug Dependence Unit, Prestwich Hospital, Manchester
Nicholas Seivewright
Affiliation:
Fosse Medical Centre, Leicester; St Charles' Hospital, London; Professorial Psychiatric Unit, Mater Misericordiae Hospital, Dublin, Ireland; Regional Drug Dependence Unit, Prestwich Hospital, Manchester
*
1Address for correspondence: Dr P. Tyrer, St. Charles' Hospital, Exmoor Street, London W10 6DZ.
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Synopsis

Follow-up by examination of medical and psychiatric records was carried out on 357 patients with conspicuous psychiatric morbidity in two general practices three years after clinical and personality assessment using structured interview schedules. One practice was an inner-city urban one and the other was rural. Full follow-up data over the 3-year period was available for 301 patients (84 3%). After three years patients with personality disorder and those in the urban practice had greater morbidity, more contacts with all levels of the psychiatric service and more psychotropic drugs, particularly benzodiazepines. Despite this increased morbidity, the number of consultations with the general practitioner for psychiatric illness was no higher in the urban group and those for medical illness were significantly higher in the rural one. The implications of the findings are discussed with particular reference to developments in community psychiatric care.

Type
Original Articles
Information
Psychological Medicine , Volume 21 , Issue 2 , May 1991 , pp. 495 - 503
Copyright
Copyright © Cambridge University Press 1991

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