Do urban environments increase the risk of anxiety, depression and psychosis? An epidemiological study

J Affect Disord. 2013 Sep 25;150(3):1019-24. doi: 10.1016/j.jad.2013.05.032. Epub 2013 Jun 3.


Background: The present study aimed to investigate whether there is an association between type of living environment (urban versus rural) and anxiety, depression and psychosis in the Scottish population.

Methods: Data were obtained from the Scottish Neighbourhood Statistics database on Scottish Index of Multiple Deprivation and urban-rural classifications for 6505 data zones across Scotland. Multiple regression was used to test the association between prescriptions for psychotropic medication for anxiety, depression and psychosis, and type of living environment according to urban-rural classification, controlling for a range of socio-economic factors.

Results: Urban-rural classification significantly predicted poorer mental health both before (β=-.29) and after (β=-.20) controlling for a large number of socio-economic variables, with more urban areas having higher rates of prescription for psychotropic medication for anxiety, depression and psychosis.

Limitations: The current study focussed on macro-level variables and did not include individual level data. As such, the study did not include data on individual diagnoses, but instead used drug prescriptions for anxiety, depression and psychosis as a proxy for level of affective disorders within data zones.

Conclusion: More urban living environments in Scotland are associated with higher rates of prescription for psychotropic medication for anxiety, depression and psychosis.

Keywords: Anxiety; Depression; Epidemiology; Psychosis; Rural; Urban.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anxiety
  • Anxiety Disorders / epidemiology*
  • Depressive Disorder / epidemiology*
  • Female
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Psychotic Disorders / epidemiology*
  • Psychotropic Drugs / therapeutic use
  • Residence Characteristics*
  • Rural Population / statistics & numerical data
  • Scotland / epidemiology
  • Urban Health*
  • Urban Population


  • Psychotropic Drugs