Self-reported outcome measures for assessing symptoms of anxiety and depression in patients with lower extremity artery disease: a scoping review

Aims Patients with lower extremity artery disease (LEAD) experience substantial psychological burden, and symptoms of anxiety and depression are associated with poorer treatment adherence, reduced quality of life, and adverse clinical outcomes. Despite the clinical relevance of systematic assessment, no consensus exists regarding the most appropriate patient-reported outcome measures (PROMs) for use in LEAD. This scoping review aimed to identify and map domain-specific PROMs used to assess symptoms of anxiety and depression in adults with LEAD to summarise key characteristics and reported psychometric properties. Methods and results A systematic search of six electronic databases was conducted on 21 August 2025. Guided by the Joanna Briggs Institute Population–Concept–Context framework, eligible studies included adults with LEAD and the use of domain-specific PROMs assessing symptoms of anxiety and depression across all healthcare settings and geographical locations. Studies using diagnostic instruments or generic PROMs only were excluded. Sixty-four studies met the inclusion criteria, reporting 16 unique instruments. The most frequently used PROMs were the Hospital Anxiety and Depression Scale (HADS) (n = 14) and the Geriatric Depression Scale (GDS) (n = 13). Study populations were predominantly male, with only five studies reporting a female majority. Reporting of psychometric properties was inconsistent, and full validation within LEAD populations was identified for one instrument only, restricted to patients with LEAD-related amputation. Conclusion PROM use in LEAD is heterogeneous, with comprehensive psychometric validation limited to one PROM in a LEAD-related amputation subgroup. Broader validation across PROMs and LEAD stages is needed, including evaluation of potential sex-related differences.