Peripheral vascular disease and depression

The occurrence of peripheral vascular disease (PVD) in our aging population is of great proportion affecting approximately 20% of the population, which extrapolates to 8 to 12 million Americans. PVD is a progressive disease that almost always includes one or more comorbidities that impact greatly on severity and management of the disease. The age of disease onset can vary but most commonly presents at age 65 years and older. Depressive symptoms in the same age group occur in 30% to 60% of individuals with PVD. When a disabling disease such as PVD is combined with the already deteriorating effects of the aging process, the risk of these patients developing depression is greatly increased. The depressive symptoms in this population of patients are often unrecognized by their primary physician. This article reviews the potential mechanisms of depression, the effects of the combination of depression and a chronic illness such as PVD, the importance of recognizing depressive symptoms, and the available treatment options. The characteristics of PVD, including the effects on physical and mental health, the signs and symptoms of major depressive disorder, and the available screening tools used to evaluate a patient who may have depression, will also be discussed.