Association between urban/rural background and the development of depressive spectrum disorders: an experience from telepsychiatry

Abstract

Introduction: one of the strategies considered when dealing with mental health problems during the COVID-19 pandemic was the use of telepsychiatry. Objective: to determine whether urban or rural origin is associated with the development of depressive disorders in patients consulting through telepsychiatry in a referral hospital in Paraguay. Methodology: observational, descriptive of cross-association, and cross-sectional study. A non-probabilistic sampling of consecutive cases was carried out. Electronic records of patients treated at the Psychiatry Service of the “Hospital de Clínicas” of the “Universidad Nacional de Asunción” between March and June 2021 were used. Descriptive statistics were applied for all variables. For the comparison of groups with nominal qualitative variables, the Chi-square test was used, calculating the odds ratio according to sex and area of residence, considering a p˂0.05 as significant. Student's t-test was also used to compare a nominal variable with a quantitative variable. Results: 907 clinical records were analyzed, finding 92 patients with depressive spectrum disorders. When analyzing the association between rural and urban environment with the presence of a depressive episode, a significant association was found between rural environment and the diagnosis of a depressive disorder (OR=7.81, χ2=63.33, p<0.001). Conclusion: our results do not agree with previous studies related to the subject. This could be due, at least in part, to the impact that social and economic conditions have on the development of mental disorders, such as depression.