Hospital-based distribution of psychiatric disorders among adults in the Psychiatry Department of the Analankininina University Hospital Center, Toamasina, Madagascar

Background: Contemporary hospital-based epidemiological data on adult psychiatric disorders in Madagascar remain scarce.

Aim: To describe the hospital-based distribution of ICD-11 psychiatric diagnoses among adults managed in the Psychiatry Department of the Analankininina University Hospital Center in Toamasina (CHUAT) between 2022 and 2024 and to explore associations with key sociodemographic characteristics. 

Methods: We conducted a retrospective cross-sectional analysis of routine clinical records for adults (≥18 years) seen in outpatient consultation and/or hospitalized during the study period. Diagnoses were made during routine clinical assessments by department clinicians using ICD-11 criteria. Descriptive statistics were used to report diagnostic frequencies and patient characteristics; bivariate associations were tested using Chi-square (p≤0.05). 

Results: Among 3,204 adult patient episodes managed in the department, 1,277 records met eligibility criteria for analysis. Women represented 51.21% of the sample. Schizophrenia (27.88%) and depressive disorders (25.84%) were the most frequent diagnoses, followed by substance use and addictive behavior disorders (15.35%), dissociative disorders (13.70%), generalized anxiety disorders (11.20%), and acute psychotic disorders (10.81%). Several diagnoses showed statistically significant bivariate associations with sex, age group, occupational status, and marital status. 

Conclusion: In this hospital-based sample from Toamasina, schizophrenia and depressive disorders were the most frequently diagnosed conditions. These findings provide updated service-level information to support planning and organization of psychiatric care in a resource-limited setting.