The Broken Hill Psychopathology Project.

The main objective of this study was to describe the psychiatric disorders seen in patients presenting for treatment in rural New South Wales. The patients were seen primarily in the community, in both public and private practice, but also in the local base hospital and prison. Seven hundred and seven patients were consecutively examined during the study period. The results of this study were compared with a previous Australia-wide study to identify specific disorders that were more prevalent in rural areas. Alcohol abuse and dependence stood out as being much more prevalent. Life problems such as domestic violence, sexual assault, and incest occurred commonly in women referred for psychiatric assessment. More than ten percent of the study patients were children aged under 17, who had similar prevalence rates of the various psychiatric disorders to a national comparison. It is concluded that alcohol abuse is very common in rural New South Wales, particularly in men, although there are also high rates in women, and this is probably related, in part at least, to the high rates of domestic violence, sexual assault and incest. It appears probable that there is a cycle of alcohol abuse in men leading to domestic violence and sexual abuse in women and children. This may contribute to the latter becoming anxious and depressed. The rates of the major functional psychiatric disorders were similar to those seen nationally. There is a great need for the maldistribution of psychiatrists between metropolitan and rural areas to be addressed.