Is vascular depression a distinct sub-type of depressive disorder? A review of causal evidence

Is vascular depression a distinct sub-type of depressive disorder? A review of causal evidence Background Vascular depression is an important conceptual and clinical concept. Objective To apply criteria which, in an ideal world, should be satisfied before an association between depression and vascular disease can be considered robust. Method A literature review with discussion of findings in the light of recently suggested guidelines for the development of new psychiatric disorders. Results There is considerable evidence linking depression in later life with vascular brain disease but the interaction is bidirectional. Depression and vascular disease could be mediated by factors other than traditional vascular risk factors. There is increasing interest in mechanisms such as inflammatory processes which may mediate both depression and vascular disease. Conclusions Vascular depression provides a useful framework with which to remind the clinician of important interactions between depression and vascular disease but conceptually it may be too restrictive. Copyright (C) 2004 John Wiley Sons, Ltd.