Women living in poor areas in the UK are almost twice as likely to develop clinical anxiety as women in richer areas. However, whether men lived in poorer or richer areas made no difference to their levels of generalized anxiety disorder (GAD). These are amongst the main findings of a major survey on how socio-economic factors affect mental health in the UK.

The study was part of the much larger EPIC program, which looked at the relationship between chronic diseases and the way people live their lives. The Cambridge group followed up the health of 11,422 women and 8,878 men resident in Norfolk, UK. Using detailed health and lifestyle questionnaires, they were able to unpick some of the factors which contributed to poor health over the 15-year period of the study.

Generalized anxiety disorder is one of the most common mental health conditions in modern society, but little objective work has taken place to show the factors in society which can lead to the development of anxiety. Now, a new study of over 20,000 men and women in Norfolk, UK, has shown some of the factors which may contribute to this problem. Amongst the main findings are:

* Women living in more deprived areas in the UK were almost twice as likely to develop GAD as those living in areas that were not deprived, but this link between poverty and GAD does not exist in men.

* Men who perceive themselves to be in poor health are over 5 times more likely to develop anxiety than men who perceive their health to be good. However, women who believe they are in poor health are only 3 times more likely to develop GAD.

* In general anxiety decreased significantly with age, in both men and women.

According to lead researcher, Olivia Remes of Cambridge, "Women living in poor neighbourhoods were at an almost two times higher risk of developing GAD than those living in less deprived neighbourhoods. This link between deprivation and mental illness, however, does not appear to exist in men. This is intriguing, and further research is needed to shed light on this".

She continued: "Our study also showed that people with poor self-perceived health were at a high risk for developing GAD. Men who perceived their health to be poor were over five times more likely to develop GAD than those who did not, and this effect persisted even when serious medical conditions were accounted for. Similar, but less pronounced findings were observed in women. It is unclear yet why the link between self-perceived health and GAD should exist. Poor self-perceived health can be a warning signal for future mental illness, however, additional research is needed to shed light on the exact mechanisms driving this association. We have found these associations, now we need to see if we can find out what causes them."

Commenting for the ECNP Communications Committee, Dr Iria Grande said : "Although it is common knowledge that gender differences exist, science has had difficulties in showing evidence in this field. This work has shed some light on how women and men deal differently with environmental factors, and the effect this has on mental health. According to this research, feeling unhealthy seems to lead to clinical anxiety more in men than women whereas living in poor areas seems to lead to clinical anxiety only in women."