Prevalence of depression and anxiety among individuals with preserved ratio impaired spirometry: a systematic review and meta-analysis.

At present, the preserved ratio impaired spirometry (PRISm) phenotype is attracting the attention of researchers as a new type of lung function impairment. Although its association with cardiovascular and metabolic diseases has been well studied, its link with mental disorders is not fully understood. Therefore, it is necessary to systematically assess the prevalence of depression and anxiety in people with PRISm. This systematic review and meta-analysis was registered in the PROSPERO database (CRD420261353805). Literature was searched in the Scopus and Web of Science, PubMed databases. Cross-sectional or cohort studies were included if the PRISm phenotype was defined by FEV1/FVC ≥ 0.70 and FEV1 < 80% predicted, and if the prevalence of depression or anxiety was reported in numerical form. Data were extracted by two independent reviewers, and pooled prevalence was calculated using a random-effects model. A total of 6 studies (N = 43,900) were included in the meta-analysis. The pooled prevalence of depression among PRISm participants was 0.17 (95% CI: 0.11-0.25). In addition, based on 5 studies (N = 42,337), the prevalence of anxiety was 0.15 (95% CI: 0.07-0.32). The prevalence varied across individual studies, and high heterogeneity was observed (I2 = 97.8% for depression and I2 = 99.5% for anxiety). Depression and anxiety are common in people with the PRISm phenotype. These findings highlight the importance of assessing mental health and early intervention in this group in clinical practice. Because of the limited number of included studies, subgroup analyses and meta-regression could not be performed, and the findings should be interpreted with caution. Future large prospective studies are needed to clarify the causal relationship between PRISm and mental disorders.