New research from the University of Southampton and King's College London has found that people who live in the most deprived areas of the UK experience post-traumatic stress disorder (PTSD) at three times the rate of those who live in more affluent areas.
The research, published today [5 September] in the European Journal of Psychotraumatology, established that people from deprived areas also experience more severe symptoms and show less of an improvement at the end of their treatment.
Extensive research has demonstrated a relationship between socioeconomic deprivation and poor mental health. Depression and anxiety have both been shown to be connected to financial strain, a lack of job and housing security, and unemployment.
This study examines the relationship between PTSD and socioeconomic deprivation, and the effectiveness of psychological treatments.
Researchers analysed anonymised electronic health records of patients who presented with PTSD symptoms in London, Yorkshire & Humber, Cambridgeshire, Cheshire and Lancashire.
Patients were referred to the national NHS Talking Therapies programme, and were offered up to 20 sessions of trauma-focused cognitive behavioural therapy (CBT), or eye-movement desensitisation and reprocessing (EMDR), delivered by qualified psychotherapists.
Analysis of the data established not only that people in socioeconomically deprived neighborhoods experience considerably higher rates of PTSD, but also that they start treatment with more severe symptoms and experience less effective treatment outcomes.
Professor Jaime Delgadillo, Professor of Clinical Psychology at King's College London and the study's lead author said: "Poverty comes with the burden of uncertainty, worry and stress over your daily survival. On top of this, living in a deprived neighbourhood increases the chances of experiencing traumatic events, which can lead to disabling symptoms, making it even more difficult to work and to overcome financial hardship. Clearly, people living in these circumstances need adequately intensive treatments to have any chance of improvement."
Further analysis suggested however that the length of treatment was an important factor when assessing the effectiveness of interventions. People from poorer areas had better outcomes if they had a longer course of treatment, with more therapy sessions.
Co-author Dr Thomas Richardson , an Associate Professor in Clinical Psychology at the University of Southampton, a leading expert on mental health and financial stress, and a co-author on the study said: "It is not exactly clear why PTSD treatment outcomes are not as good for patients living in poorer areas, we need further research on this.
"What is clear is that there is a huge inequality here. If you are living in a deprived area you are more likely to be exposed to traumatic events such as being the victim of violent crime, more likely to develop PTSD, and more likely to have severe symptoms. But then when you go to get help for this, therapy is not likely to be as helpful as it is for those from richer areas. We need to do better to improve treatment outcomes for patients living in deprived areas."
