Mental Illness and Social Conditions in Bristol

In a pioneer work, Faris and Dunham (1939) studied the distribution of mental disorders in Chicago. Essentially their findings were that the incidence of schizophrenic cases was highest in the central areas of low social and economic status and lowest in the affluent residential districts on the periphery; that the differential distribution of cases of senile and arteriosclerotic dementia was similar to but less marked than that of schizophrenia; but that cases of manic-depressive psychosis were much more evenly distributed throughout the city though with a tendency to higher rates in better-class areas. They concluded that “social isolation”—the fact that in the central area of the city a person tended to be cut off from intimate and lasting emotional relations with other people—was a causal element in schizophrenia and that this accounted for the observed difference of incidence. Their findings have been confirmed in nine other American cities (Clark, 1949) but there have hitherto been no reports of similar studies outside the United States. The aim of the present study was to test, in an English city, the observations of Faris and Dunham on the urban distribution of mental disorders, and, by relating the distribution to various indices of social and economic status, to determine whether any additional evidence could be found for the hypothesis that social isolation is a factor in causing schizophrenia.