Abstract
Objective: To determine the frequency of ruminations in patients with depression admitted in a tertiary care hospital.
Methodology: This cross-sectional, observational study was done at the Department of Psychiatry and Behavioral Sciences, Government Allama Iqbal Memorial Hospital Sialkot, Pakistan from August 2015 to July 2016. We included 324 adult inpatients suffering from depression. Excluded from the study were the patients with other psychiatric illnesses, other co-morbid psychiatric or medical illnesses, impairment of cognition, and severe psychotic symptoms. After written informed consent, demographic details were taken. Depression was assessed by detailed clinical interview by a consultant Psychiatrist. Out of the total 324 depressed inpatients 109 were males and 215 were females. Among the males, 3 (2.75%) had mild depression, 35 (32.11%) had moderate depression and 71 (65.13%) had severe depression. Among the 215 female patients 7 (3.25%) had mild depression while 64 (29.77%) had moderate depression and 144 (66.97%) had severe depression. Then, Urdu version of the depression subscale of hospital anxiety and depression scale and Ruminative response scale were administered. Statistical analysis was done by using SPSS version 21.
Results: Out of the 324 (109 males and 215 females) inpatients with depression 159 (49.07%) had ruminations. Among the male inpatients brooding only, reflection only and having both brooding and reflection were 19.26%, 9.16% and 2.74% respectively while in the females it was 40.92%, 13.48% and 3.72%. A total of 31.19% of the males had ruminations while 58.13% of the females had ruminations. None of the patients with mild depression had ruminations while 9.87% of the patients with moderate depression and 39.19% with severe depression had ruminations.
Conclusion: Almost half (49.07%) of the inpatients with depression had ruminations. Females had almost double the frequency of ruminations than males. Frequency of brooding rumination was higher in female inpatients. Inpatients with severe depression had 39.19% ruminations as compared to 9.87% in moderate depression.

Key words: Depression, rumination, inpatient, tertiary care.