Schizophrenia and Bipolar Disorder in Urban Areas

Background Earlier studies have shown that schizophrenic patients are more likely to be living in densely populated inner city areas, whereas bipolar patients are more widely distributed. These studies, however, were generally carried out in the pre-community psychiatry era. Aim of this study To examine the geographical distribution of cases of schizophrenia and bipolar disorder in an urban area of West Yorkshire to see if the drive towards care in the community has led to wider dispersion of cases. Method Admissions of schizophrenic and bipolar patients to in-patient facilities of Leeds Mental Health Teaching NHS Trust over a 3-year period were mapped to the electoral wards in which they were living at the time of admission. Results 949 cases of schizophrenia and 930 cases of bipolar disorder were hospitalized over this period. At the time of admission significantly more schizophrenic and bipolar patients were residing in inner city areas of Leeds. Conclusion Closure of large mental hospitals and the trend towards management of psychiatric patients in the community does not appear to have had an appreciable effect on the concentration of schizophrenic patients in densely populated inner city areas. Surprisingly, the bipolar population is also following the same trend. Competing Interests Nil Details of contributors This study was carried out by a group of 4th year medical students, as the Selected Study Component of their Psychiatry, Primary care and Public Health module. Dr T Mahmood, as supervisor, planned the study and critically revised the draft