FREQUENCY OF MOOD DISORDERS IN PATIENTS ATTEMPTING SUICIDE WHO ARE REFERRED TO THE PSYCHIATRY WARD IN A TERTIARY CARE HOSPITAL OF KARACHI: A CROSS-SECTIONAL STUDIES

Abstract

Background: Suicide remains a major cause of preventable mortality worldwide, with more than 700,000 deaths recorded annually. Low- and middle-income countries carry the largest burden, yet local data remain limited due to under-reporting and stigma. Pakistan faces a growing concern with suicide attempts, but hospital-based evidence is scarce. Identifying psychiatric morbidity—especially mood disorders—among attempters can guide early detection, treatment allocation, and prevention strategies in tertiary-care settings.

Objective: To estimate the frequency of mood disorders among adults referred to the psychiatry ward following a suicide attempt at a tertiary-care hospital in Karachi and to describe their sociodemographic and clinical characteristics.

Methods: A descriptive cross-sectional study was conducted over six months in the Department of Psychiatry and Behavioral Sciences, Jinnah Postgraduate Medical Centre (JPMC), Karachi. Consecutive adult patients (≥18 years) referred after a medically stabilized suicide attempt were included (n = 385). Data collection involved a structured questionnaire for sociodemographics and clinical history, alongside validated tools: the Patient Health Questionnaire-9 (PHQ-9) and the Young Mania Rating Scale (YMRS). Diagnoses of depressive disorder and bipolar affective disorder were confirmed by consultant psychiatrists using DSM-5 criteria. Data were analyzed in SPSS v26. Continuous variables were expressed as mean ± standard deviation (SD) and categorical variables as frequencies and percentages. Associations between mood-disorder category and past suicide-attempt history were assessed using chi-square tests.

Results: The mean age of participants was 33.16 ± 13.35 years and mean BMI was 24.52 ± 4.37 kg/m². Most participants were married (194, 50.4%) and the majority were referred from the Emergency Department (285, 74.0%). Poisoning was the predominant method of attempt (213, 55.3%), followed by overdose (71, 18.4%) and hanging (35, 9.1%). A past suicide attempt was reported by 108 (28.1%). Current psychiatric diagnosis revealed depressive disorder in 223 (58.0%), bipolar affective disorder in 56 (15.0%), and no mood disorder in 106 (28.0%). PHQ-9 scores averaged 17.65 ± 6.23, falling in the moderately severe range, while YMRS scores averaged 21.85 ± 7.40. No significant association was observed between mood-disorder category and past attempt history (χ² p = 0.474).

Conclusion: The study demonstrated that mood disorders, particularly depression, were highly prevalent among adult suicide attempters in a tertiary hospital in Karachi. The high severity of symptoms and predominance of poisoning as a method underscore the urgent need for routine PHQ-9/YMRS screening, structured safety planning, and integrated emergency–psychiatry care pathways. Strengthening hospital-based psychiatric services and follow-up systems is crucial to improve outcomes and reduce recurrence risk in this vulnerable population.