Comparative analysis of pulmonary function in school-going adolescents: Examining the impact of depression and anxiety

Given the rising concern over depression and anxiety among adolescents, this study aims to investigate their potential impact on respiratory health by comparing pulmonary function test (PFT) parameters between healthy adolescents and those with either depression or anxiety or those exhibiting symptoms of both depression and anxiety. In this cross-sectional study, a random sample of school-going adolescents aged 13–18 years from various schools in Sikkim, both males and females, were selected. Depression and anxiety were assessed using the Revised Children’s Anxiety and Depression Scale-25, and pulmonary function was measured using a computerised spirometer-Spirolab III. The recorded variables included forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), FEV1/FVC ratio, peak expiratory flow rate (PEFR) and forced expiratory flow at 25–75% (FEF 25–75%). Significant differences emerged in FVC (P = 0.034), PEFR (P = 0.013) and FEF 25–75% (P = 0.023) between healthy and depressed adolescents aged 13–18 years. Similarly, a significant difference was observed in PEFR (P = 0.022) and FEF 25–75% (P = 0.002) between healthy adolescents and those with symptoms of both depression and anxiety. These differences were more pronounced among students in higher grades. Furthermore, significant differences in PEFR (P = 0.015) and FEF 25–75% (P ≤ 0.001) were found while comparing healthy males and males with symptoms of both depression and anxiety. However, no such disparities were seen in girls. There was no significant difference in any of the parameters when compared between the healthy group and those with anxiety. Depressed adolescents exhibited significantly reduced FVC, PEFR and FEF 25–75% compared to their healthy counterparts, despite being otherwise healthy. This negative association was more pronounced in the higher age group. However, anxious adolescents did not show any significant difference in PFT compared to healthy peers.