Exploring the link between post-thrombotic syndrome and depression: a narrative review on current evidence

Post-thrombotic syndrome is a chronic and challenging complication following deep venous thrombosis, that impacts a significant proportion of patients, despite anticoagulation therapy. Emerging evidence suggests a strong association between PTS and depression, with shared inflammatory mechanisms possibly linking the two conditions. This study aims to explore the potential pathophysiological connection between PTS and depression, focusing on the role of inflammatory mediators.

A comprehensive literature review was conducted across PubMed, Scopus, and Embase, analyzing articles published between 2009 to 2024. The search was divided into three phases: assessing the relationship between PTS and depressive symptoms, PTS and inflammatory mediators, and depression or depressive symptoms and inflammatory mediators. A total of 31 articles were selected based on specific inclusion criteria.

The literature search yielded 3682 articles, of which 31 met the inclusion criteria and underwent full-text review. The evidence that currently exists regarding PTS and depression is scarce, and studies have not elucidated mechanisms that explain this relationship. However, this review proposes that both depression and PTS share multiple common inflammatory markers such as IL-6, CRP and IL-10.

The association between PTS and depression, underscores the need for integrated care approaches that address physical and mental health. Inflammation appears to be a critical link, offering a potential target for therapeutic strategies that could improve patient outcomes. Further research is necessary to fully understand this connection and develop comprehensive treatment models that address the physical and psychological aspects of PTS.