Association between impairment of lung function and risk of anxiety and depression in patients with chronic obstructive pulmonary disease - A systematic review

Abstract

Background: This systematic review aims to evaluate the association between impairment of pulmonary function, anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). Methods: Literature search were performed using Embase and PubMed. Publications reporting association between forced expiratory volume in one second in percentage of expected value (FEV1(%)) and anxiety or depression in patients with COPD were included. Results: 31 studies were included in the review, 15 allocated to anxiety group and 31 allocated to the depression group. Most were observational studies. Study population sizes ranged from 40 to 2147 patients. Three studies found a significant negative association between anxiety and FEV1(%), while five studies found a positive non-significant association between anxiety and FEV1(%). Fifteen studies found a significant negative association between FEV1(%) and depression. Especially the studies with larger study population sizes showed significant results. Conclusion: This systematic review did not support an association between anxiety and impairment of pulmonary function as only 3/15 studies showed significant negative associations and some studies showed positive associations. This review indicated an association between depression and impairment pulmonary function in patients with COPD, as most studies with a larger study population size showed a significant negative association. Registration: PROSPERO 2024 CRD42024506065