Association between the condition of living alone and the presence of depressive symptoms in adults in Peru: an analysis of nationally representative survey data

Introduction. Depression is a major public health problem that affects quality of life, social functioning, and overall well-being. Among the social factors potentially related to depressive symptoms, living alone has gained increasing attention, although findings have been inconsistent across settings. In Peru, where household composition and social support dynamics may differ from those reported in other contexts, evidence on this association remains limited. Therefore, this study aimed to determine the association between living alone and depressive symptoms in Peruvian adults. Methods. This observational, cross-sectional, and analytical study used secondary data from the 2022 Demographic and Family Health Survey (ENDES), conducted in 30,087 Peruvian adults aged 18 years old and older. The dependent variable was the presence of moderate to severe depressive symptoms (yes/no), measured by the Patient Health Questionnaire-9 (PHQ-9), while the independent variable was living alone (yes/no). Generalized linear models of the Poisson family and log link function, were used to estimate crude and adjusted prevalence ratios (PRs). The analyses were performed in Stata v18.0 with a significant level of 5%. Results. Moderate to severe depressive symptoms was identified in 7.9% of participants, while 7.5% lived in single-person households. In the crude analysis, living alone were associated with a higher probability of presenting depressive symptoms (PR: 1.60; 95% CI: 1.33-1.92; p < 0.001). However, after adjusting for confounding variables, the association ceased to be significant (aPR: 1.01; 95% CI: 0.82-1.24; p = 0.928). Conclusion. Unlike studies where living alone is associated with a higher prevalence of depressive symptoms, in the Peruvian context, no statistically significant association was observed in the adjusted analysis. This finding suggests that other social and cultural determinants may be associated with depressive symptoms among adults living alone in Peru. Understanding these differences is key to the design of mental health prevention and intervention strategies adapted to the specific characteristics of the population.