Depression is a common disease throughout the world, and it is estimated that it affects more than 300 million people, being an important cause of functional disability, during the pandemic, one of the strategies that were considered when it came to palliating the mental health consequences of the COVID-19 pandemic was the use of telepsychiatry. Telepsychiatry is not a new strategy for medicine; however, the pandemic has created a favorable scenario for its application in different services and its use as a way to prevent exacerbations and "novo" symptoms, including depressive symptoms. The objective of this research was to determine if the urban origin or rural is associated with the development of depressive disorders in patients who consult through telepsychiatry in a reference hospital in Paraguay, through an observational, descriptive cross-sectional association study. A non-probabilistic sampling of consecutive cases was carried out. Electronic files of patients treated in the Psychiatry Service of the Hospital de Clínicas of the National University of 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. In addition, the Student's t-test was used to compare a nominal variable with a quantitative variable.Having as a result, 92 patients with depressive spectrum disorders. When analyzing the association between the rural and urban environment with the presence of a depressive episode, a significant association was found between the rural environment and the diagnosis of a depressive disorder (OR=7.81, χ2=63.33, p<0.001 ), for which it was determined that the 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.