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[Diagnosis and type of residence at the time of first consultation at a psychiatric outpatient clinic].

Over a five-year period of registration in the county of Sør-Trøndelag we studied whether the frequency of consulting for one of three major psychiatric diagnostic groups (psychosis, neurosis, or "other") depended on the type of municipality (rural, coastal, urban) where the patient was resident. Diagnoses were based on consultations with a staff member of the regional outpatient psychiatric clinic, and the underlying population was described in the National Census, 1980. The results showed that, in general, urban residents sought help more frequently from the psychiatric outpatient clinic than rural residents did, (relative risk = 1.6, 95% confidence interval 1.4 to 1.8). The increased "risk" was attributed to a relatively larger number of neuroses and "other" diagnoses in the urban areas. The risk of consulting for psychosis was higher among coastal residents (relative risk = 1.8, 95% confidence interval 1.4 to 2.3) than among rural residents, was particularly evident among coastal residents between 16 and 39 years of age (relative risk = 4.1, 95% confidence interval 2.1 to 8.5), and was equally strong for men as for women. This study confirms that, in general, the risk of seeking outpatient psychiatric treatment is higher among urban than among rural and coastal residents. The apparently higher frequency of requests to the outpatient clinic for help for psychosis among coastal residents should be balanced against the tendency for city residents with psychosis to be admitted directly to the psychiatric hospital.