Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116809
Revised: January 19, 2026
Accepted: March 4, 2026
Published online: June 19, 2026
Processing time: 163 Days and 0.7 Hours
Irreversible airflow limitation is the hallmark of a progressive respiratory disorder known as chronic obstructive pulmonary disease (COPD). Depression and anxiety are common mental health problems that can happen with COPD and can make the disease worse. However, the extent to which they affect the rate of lung function decline is not yet known.
To examine how depression and/or anxiety, when present as comorbid condi
From July 2022 to July 2025, 122 patients with stable COPD received continuous treatment and regular spirometric follow-up for up to three years at our hospital. We retrospectively analysed the data from these patients. Patients were assessed on two occasions, enabling the calculation of their yearly rate of lung function decline. Patients were divided into two groups. The first group was the control group. This included patients with COPD alone (n = 58). The second group was the comorbidity group. This included patients with COPD and depression and/or anxiety (n = 64). We used something called “linear mixed-effects models” to compare changes over time in something called “forced expiratory volume in one second (FEV1)”. We also used something called “multivariate linear regression analyses” to find out what causes a faster decline in lung function.
At the start of the study, patients with depression and/or anxiety as well as the disease had a lower FEV1, FEV1% predicted, and FEV1/forced vital capacity ratios, and had more acute exacerbations and inhaled corticosteroid use than the control group (all P < 0.05). After the study, the yearly decrease in lung function was a lot higher in the group with both conditions than in the control group (52.4 ± 10.8 mL/year vs 41.3 ± 9.5 mL/year, P < 0.001). After adjustment for age, sex, body mass index, smoking status, and baseline lung function, faster FEV1 decline was found to be independently associated with comorbid depression/anxiety (β = -10.92, 95% confidence interval: -17.35 to -4.49, P = 0.001). More detailed analysis showed that depression/anxiety was the biggest thing that made lung function get worse faster.
The rate of annual lung function decline in COPD was found to be independently accelerated by comorbidity, specifically depression and/or anxiety. This highlights the significance of incorporating psychological assessments and integrated management strategies during long-term follow-ups to decelerate disease progression.
Core Tip: It has been demonstrated by this retrospective study that a significantly faster decline in forced expiratory volume in one second is experienced by patients with chronic obstructive pulmonary disease and comorbid depression and/or anxiety compared with those without psychological comorbidities. These findings highlight that psychological well-being is an independent hazard for the advancement of chronic obstructive pulmonary disease and should be incorporated into all-encompassing disease management tactics.