Citation

Simone C, Carolin L, Max S, Reinhold K. Soc. Psychiatry Psychiatr. Epidemiol. 2013; 48(11): 1797-1808.

Affiliation

Department of Psychiatry and Psychotherapy II, University of Ulm at Bezirkskrankenhaus Günzburg, Günzburg, Germany, simone.cramer@gmail.com.

Copyright

(Copyright © 2013, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00127-013-0667-1

PMID

23460045

Abstract

PURPOSE: Neighbourhood characteristics are known to be associated with higher rates of hospital admission for psychiatric disorders. METHODS: An ecological study with aggregated data was carried out. All cases for schizophrenia and depression in the 42 city districts of Augsburg were identified over a 4-year-period (2006-2009) and neighbourhood variables were obtained. Negative binomial regression adjusted the effects for year of admission and accommodation in inpatient centres. RESULTS: There was significant association of high unemployment rate, low proportion of working population and high population density with higher rates of admission for schizophrenia. An increase of 1 % in unemployment rate [incidence rate ration (IRR) 1.0451, 95 % CI 1.0175-1.0734] was associated with 5 % raise of admission rates for schizophrenia and an increase of 1 % in working population (IRR 0.9793, 95 % CI 0.9605-0.9985) with a decrease of admission rates by 2 %. High proportion of single households and high percentage of persons eligible for social security increased admission rate for depression. Thus 1 % increase in the proportion of single households (IRR 1.0095, 95 % CI 1.0030-1.0162) and of the proportion of persons eligible for social security (IRR 1.0148, 95 % CI 1.0002-1.0297) both independently were associated with an increased rate of admission for depression of 1 %. CONCLUSION: Our analysis demonstrated that measures of social isolation in neighbourhoods and social contacts at work influenced admission for schizophrenia and depression: in neighbourhoods with less social contacts and with a higher proportion of persons not working the admission rates increased. The problem of confounding in ecological studies need to be considered.

Language: en