Depression is one of the major psychological disorders in Pakistani population. It is characterized by loss of interest in daily activities, lack of sleep, consistent feelings of guilt and poor concentration. This study aimed for determination and evaluation of depression patients in various geographical zones of the Khyber Pakhtunkhwa province of Pakistan. The correlations of disease severity, symptoms variability with various contributing factors in respective zonal region were evaluated. This multicenter, randomized, cross sectional study was conducted in psychiatry wards at various tertiary care hospitals of Peshawar. For the purpose of the study, the province was divided into four geographical zones. Areas with similar life styles, quality of life and relative vicinity were grouped together. A total of 200 patients belong to the above stated classified zones, with positive diagnosis of depression by DSM-IV criteria, presented continuously for minimum two weeks tenure were included in this study. Their severity of symptoms and level of depression was categorized into mild, moderate and severe depression using the internationally recognized rating

scale i-e; Hamilton Depression Rating Scale-17. Exclusion criteria for the patients involved subjects with severe comorbidities, drug induced depression and postpartum depression. In all 4 zones, the prevalence of depression was higher in females than that of males. Similarly, distribution based on severity level showed that majority female patients were moderately depressed. Age wise severity levels showed that in patients aging 17-40 year, majority of the patients were suffering from moderate depression. In contrast, patients aging >40 years, majority of them were diagnosed with severe depression. Among various considered and assessed factors, social factor had the most significant contribution in the development of this illness. The overall prevalence of depression in females was higher as compared to males. Social issues were the highest contributors toward depression in all four zones. The highest percentage of severe depression was found in age group above 40 years in all 4 zones. Similarly, the overall percentages of severe cases were higher in female patients than its counterpart.