Influence of socio-economic deprivation on the prevalence and outcome of depression in primary care

The Hampshire Depression Project

OSTLER, K.
THOMPSON, C.
KINMONTH, A.-L. K.
PEVELER, R. C.
STEVENS, L.
STEVENS, A.

K. OSTLER, MRCPsych, C. THOMPSON, FRCP, A.-L. K. KINMONTH, FRCGP, R. C. PEVELER, FRCPsych, L. STEVENS, MRCPsych, A. STEVENS, FRCP, Community Based Clinical Sciences Research Division, Faculty of Medicine, Health and Biological Sciences, University of Southampton

Correspondence: C. Thompson, Department of Psychiatry, Royal South Hants Hospital, Brinton's Terrace, Southampton SO14 0YG

(First received 19 November 1999, final revision 5 April 2000, accepted 19 June 2000)

British Journal of Psychiatry 178:p 12-17, January 2001.

Background

Health inequalities exist for many disorders, but the contribution of deprivation to the prevalence and outcome of depressive symptoms in primary care populations has been infrequently studied.

Aims

To examine the influence of Jarman under-privileged area (UPA) scores on the prevalence and outcome of depressive symptoms in general practice patients.

Method

18 414 patients attending 55 representative practices completed the Hospital Anxiety and Depression Scale and a questionnaire for employment status. Outcome of those screening positive was assessed at 6 weeks and 6 months.

Results

The UPA score accounted for 48.3% of the variance between practices in prevalence of depressive symptoms. Attending a high UPA score practice predicted persistence of depressive symptoms to 6 months.

Conclusions

The socio-economic deprivation of a practice locality is a powerful predictor of the prevalence and persistence of depressive symptoms.

Declaration of interest

The study was funded by the Medical Research Council. No conflict of interest known.