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Abstract
Objective: To assess the level of perceived social support among public sector employees diagnosed with mood disorders and examine its association with selected demographic and occupational factors among those receiving psychiatric care at a tertiary care hospital in Karachi.
Methods: A cross-sectional study was conducted over six months in the Department of Psychiatry and Behavioral Sciences. Consecutive public-sector employees (≥18 years) with clinician-confirmed mood disorders (depressive disorders, bipolar affective disorder, dysthymia, and cyclothymia) were enrolled after providing informed consent (n=385). The data included demographics, occupational factors, clinical history, PHQ-9, Young Mania Rating Scale (YMRS), and the Multidimensional Scale of Perceived Social Support (MSPSS). The MSPSS totals were categorised as low (12–35), moderate (36–60), or high (61–84). Analyses were performed using SPSS v27, employing descriptive statistics and chi-square tests for association.
Results: The mean age was 36.16±8.4 years, and 54% were married. The diagnoses were depressive disorder (59%), bipolar affective disorder (25%), dysthymia (11%), and cyclothymia (5%). The mean MSPSS total score was 58.51±9.31 (95% CI 57.58–59.44); distribution: moderate 58% (n=224), high 41% (n=157), and low 1% (n=4). Mean PHQ-9 was 9.14±5.58 (95% CI 8.58–9.70); YMRS 8.05±8.17 (95% CI 7.23–8.87) (no mania/hypomania 81%). MSPSS categories did not differ significantly by age (χ²=12.98, df=8, p=0.14), monthly income (χ²=6.73, df=8, p=0.716), duration of service (χ²=9.54, df=6, p=0.137), weekly work hours (χ²=2.50, df=6, p=0.881), or marital status (χ²=7.95, df=8, p=0.437).
Conclusion: Perceived social support in this clinical workforce cohort was generally moderate to high and did not vary significantly across common demographic and occupational groups. Despite the substantial depressive symptom burden and minimal manic activity, these findings suggest that strengthening family- and peer-based support within routine psychiatric care may further improve clinical outcomes. Future longitudinal research is needed to determine whether higher levels of perceived social support, as measured by the Multidimensional Scale of Perceived Social Support (MSPSS), predicts symptom improvement and functional recovery over time.
Keywords: Social Support, Mood Disorders; Depression; Bipolar Disorder; Psychiatric Care, Mental Health Services.
References
World Health Organization. Mental health [Internet]. Geneva: World Health Organization; [date of last update not stated on page] [cited 2026 Jul 23].
Hilton MF, Whiteford HA, Sheridan JS, Cleary CM, Chant DC, Wang PS, et al. The prevalence of psychological distress in employees and associated occupational risk factors. J Occup Environ Med. 2008;50(7):746-757. https://doi.org/10.1097/JOM.0b013e31817e9171
Farooq S, Khan T, Zaheer S, Shafique K. Prevalence of anxiety and depressive symptoms and their association with multimorbidity and demographic factors: a community-based, cross-sectional survey in Karachi, Pakistan. BMJ Open. 2019;9(11):e029315. https://doi.org/10.1136/bmjopen-2019-029315
Vig KD, Mason JE, Carleton RN, Asmundson GJG, Anderson GS, Groll D. Mental health and social support among public safety personnel. Occup Med (Lond). 2020;70(6):427-433. https://doi.org/10.1093/occmed/kqaa129
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988;52(1):30-41. https://doi.org/10.1207/s15327752jpa5201_2
Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55(3-4):610-617. https://doi.org/10.1080/00223891.1990.9674095
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-435. https://doi.org/10.1192/bjp.133.5.429
Perry BL, Pescosolido BA. Social network activation: the role of health discussion partners in recovery from mental illness. Soc Sci Med. 2015;125:116-128. https://doi.org/10.1016/j.socscimed.2013.12.033
Javed A, Khan MN, Nasar A, Rashid A. Mental healthcare in Pakistan. Taiwan J Psychiatry. 2020;34(1):6-14. https://doi.org/10.4103/TPSY.TPSY_8_20
Arias D, Saxena S, Verguet S. Quantifying the global burden of mental disorders and their economic value. EClinicalMedicine. 2022;54:101675. https://doi.org/10.1016/j.eclinm.2022.101675
Dayani K, Zia M, Qureshi O, Baig M, Sabri T. Evaluating Pakistan's mental healthcare system using World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). Int J Ment Health Syst. 2024;18:32. https://doi.org/10.1186/s13033-024-00646-6
Li G, Li Y, Lam AIF, Tang W, Seedat S, Barbui C, et al. Understanding the protective effect of social support on depression symptomatology from a longitudinal network perspective. BMJ Ment Health. 2023;26(1):e300802. https://doi.org/10.1136/bmjment-2023-300802
Zell, E., & Stockus, C. A. (2025). Social support and psychological adjustment: A quantitative synthesis of 60 meta-analyses. American Psychologist, 80(1), 33–46. https://doi.org/10.1037/amp0001323
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Copyright (c) 2026 Hafsa Zarnab, Chooni Lal, Zaib Un Nisa, Muhammad Azeem Rao, Najeebullah Chughtai, Shiraz Mazhar