Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T06:09:12.511Z Has data issue: false hasContentIssue false
  • English
  • Français

Socio-economic deprivation and the prevalence and prediction of depression in older community residents

The MRC–ALPHA study

Published online by Cambridge University Press:  03 January 2018

K. C. M. Wilson ,
S. Taylor ,
J. R. M. Copeland ,
R. Chen  and
C. F. M. McCracken
K. C. M. Wilson*
Affiliation:
Department of Psychiatry, University of Liverpool, EMI Academic Unit, St Catherine's Hospital, Birkenhead
S. Taylor
Affiliation:
Department of Psychiatry, University of Liverpool, EMI Academic Unit, St Catherine's Hospital, Birkenhead
J. R. M. Copeland
Affiliation:
Department of Psychiatry, University of Liverpool, EMI Academic Unit, St Catherine's Hospital, Birkenhead
R. Chen
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
C. F. M. McCracken
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
*
Professor K. C. M. Wilson, Department of Psychiatry, University of Liverpool, EMI Academic Unit, St Catherine's Hospital, Church Road, Birkenhead CH42 0LQ. Tel: 0151-604 7333; Fax: 0151-653 3441
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The Townsend index is a measure of social deprivation. It can be applied to postal districts and has been employed in studies examining the ecological associations of mental illness.

Aims

We examine the utility of the Townsend index in identifying older populations with a high prevalence and risk of developing depression.

Method

The study was carried out in the context of a cohort study of an age- and gender-stratified sample of 5222 community residents aged 65 years and over. Subjects were interviewed at intervals of two years. The relationships between Townsend score and psychiatric diagnoses (in particular, depression) were examined.

Results

High Townsend scores were associated with increased prevalence and incidence of depression and prevalence of organic psychiatric illness.

Conclusions

The Townsend index can be used to prioritise psychiatric and primary care resources so as to cater for older populations likely to suffer from depression and organic psychiatric conditions.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 6 , December 1999 , pp. 549 - 553
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

The ALPHA study was funded by a Medical Research Council Special Project Grant.

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Bezeval, M., Judge, K. & Whitehead, M. (1995) Tackling Inequalities in Health: Agenda for Action. London: King's Fund.Google Scholar
Cassel, J. (1976) The contribution of the social environment to host resistance. American Journal of Epidemiology, 104, 107–123.Google Scholar
Copeland, J. R. M., Kellehar, M. J., Kellett, J. M., et al (1976) A semistructured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule I. Development and reliability. Psychological Medicine, 6, 439–449.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) A computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine. 16, 89–99.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1990) Dementia and depression in elderly persons: AGECAT compared with DSM–III and pervasive illness. International Journal of Geriatric Psychiatry, 5, 47–51.Google Scholar
Copeland, J. R. M., Davidson, I. A., Dewey, M. E., et al (1992) Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool, British Journal of Psychiatry, 161, 230–239.Google Scholar
Eachus, J., Williams, M., Chan, P., et al (1996) Deprivation and cause specific morbidity: evidence from the Somerset and Avon survey of health. British Medical Journal, 312, 287–291.CrossRefGoogle ScholarPubMed
Gunnell, D. J., Peters, T. J., Kamrneriing, R. M., et al (1995) Relationship between parasuicide, suicide, psychiatric admissions and socio-economic deprivation. British Medical Journal, 311, 226–230.CrossRefGoogle Scholar
Gurland, B. J. (1983) The Mind and Mood of Ageing. New York: Haworth Press.Google Scholar
Gurland, B. J., Fleiss, J. L., Goldberg, K., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly The Geriatric Mental State Schedule 2. A factor analysis. Psychological Medicine, 6, 451–459.Google Scholar
Kahn, H. A. & Sempos, C. T. (1989) Statistical Methods in Epidemiology, New York: Oxford University Press.Google Scholar
Marmot, M., Ryff, C., Burnpass, L., et al (1997) Social inequalities in health: next questions and converging evidence. Social Service and Medicine, 44, 901–910.Google Scholar
Morris, M. & Carstalres, V. (1991) Which deprivation? A comparison of selected deprivation indexes. Journal of Public Health Medicine, 13, 3188–326.Google Scholar
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135–142.Google Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.Google Scholar
Romaniuk, M., McAuley, W. & Arling, G. (1993) An examination of the prevalence of mental disorders among the elderly community. Journal of Abnormal Psychology, 92, 458–467.Google Scholar
Saunders, P. A., Copaland, J. R. M., Dewey, M. E., et al (1993) The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC–ALPHA study. International Journal of Epidemiology 22, 838–847.Google Scholar
Sharma, V. K., Copeland, J. R., Dewey, M. E., et al (1998) Outcome of depressed elderly living in the community in Liverpool: a five year follow-up study. Psychological Medicine, 28, 1329–1337.Google Scholar
SPSS (1997) SPSS for Windows Base System User's Guide. Release 8.00. Chicago. IL: SPSS Inc.Google Scholar
Townsend, P., Phillimore, P. & Beattle, A. (1988) Health and Depression. Inequality and the North. London: Croom Helm.Google Scholar
van Duijn, C. M. & Hofman, A. (1992) Risk factors for Alzheimer's disease: the Eurodem collaborative re-analyses of case–control studies. Neuroepidemiology, 11 (suppl.), 106–113.Google Scholar
Verheij, R. A. (1996) Explaining urban–rural variations in health: a review of the interactions between individual and environment. Social Science and Medicine, 42, 923–935.Google Scholar
Warheit, G. L. & Holzar, C. E. (1973) An analysis of social class and racial differences in depressive symptomatology: a community study. Journal of Health and Social Behavior, 14, 291–299.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.