Urbanisation and incidence of psychosis and depression - Follow-up study of 4.4 million women and men in Sweden

Background Previous studies of differences in mental health between urban and rural populations are inconsistent. Aims To examine whether a high level of urbanisation is associated with increased incidence rates of psychosis and depression, after adjustment for age, marital status, education and immigrant status. Method Follow-up study of the total Swedish population aged 25-64 years with respect to first hospital admission for psychosis or depression. Level of urbanisation was defined by population density and divided into quintiles. Results With increasing levels of urbanisation the incidence rates of psychosis and depression rose. In the full models, those living in the most densely populated areas (quintile 5) had 68-77% more risk of developing psychosis and 12-20% more risk of developing depression than the reference group (quintile 1). Conclusions A high level of urbanisation is associated with increased risk of psychosis and depression for both women and men. Declaration of interest None.