title: Self-reported symptoms of depression and memory dysfunction in survivors of ARDS.
abstract: BACKGROUND
  Survivors of ARDS have well documented physical limitations, but psychological effects are less clear. We determined the prevalence of self-reported depression and memory dysfunction in ARDS survivors.
  
  
  METHODS
  Six to 48 (median 22) months after ICU discharge, we administered instruments assessing depression symptoms (Beck Depression Inventory-II [BDI-II]) and memory dysfunction (Memory Assessment Clinics Self-Rating Scale [MAC-S]) to 82 ARDS patients who were enrolled in a prospective cohort study in four university-affiliated ICUs.
  
  
  RESULTS
  Sixty-one (74%), 64 (78%), and 61 (74%) patients fully completed the BDI-II, MAC-S (Ability subscale), and MAC-S (Frequency of Occurrence subscale) instruments. Responders (similar to nonresponders) were young (median 42 years, interquartile range [IQR] 35 to 56), with high admission illness severity and organ dysfunction. The median BDI-II score was 12 (IQR 5 to 25). Twenty-five (41%) patients reported moderate-severe depression symptoms and were less likely to return to work than those with minimal-mild symptoms (8/25 [32%] vs 25/36 [69%]; p = 0.005). Median MAC-S (Ability) and MAC-S (Frequency of Occurrence) scores were 76 (IQR 61 to 93) and 91 (IQR 77 to 102), respectively; 8%, 16%, and 20% scored > 2, > 1.5, and > 1 SD(s), respectively, below age-adjusted population norms for each subscale. BDI-II and MAC-S scores were negatively correlated (Spearman coefficient -0.58 and -0.50 for Ability and Frequency of Occurrence subscales, respectively; p < 0.0001). Univariable analyses showed no demographic or illness-severity predictors of BDI-II (including the Cognitive subscale) or MAC-S (both subscales); results were similar when restricted to patients whose primary language was English.
  
  
  CONCLUSIONS
  ARDS survivors report a high prevalence of depression symptoms and a lower prevalence of memory dysfunction 6 to 48 months after ICU discharge. Depression symptoms may hinder the return to work, or patients may report these symptoms because of inability to re-enter the workforce.
authors.affiliation: Interdepartmental Division of Critical Care and Department of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: neill.adhikari@utoronto.ca.
authors.forename: Neill K J
authors.initials: NKJ
authors.lastname: Adhikari
authors.affiliation: Krembil Neuroscience Program, University Health Network, Toronto, ON, Canada.
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: McAndrews
authors.affiliation: Medical-Surgical Intensive Care Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Tansey
authors.affiliation: Medical-Surgical Intensive Care Unit, University Health Network, Toronto, ON, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Matté
authors.affiliation: Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Pinto
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Cheung
authors.affiliation: Women's Health Program, University Health Network, Toronto, ON, Canada.
authors.forename: Natalia
authors.initials: N
authors.lastname: Diaz-Granados
authors.affiliation: Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada.
authors.forename: Aiala
authors.initials: A
authors.lastname: Barr
authors.affiliation: Interdepartmental Division of Critical Care and Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Herridge
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000523:psychology*; D012647:Self-Assessment; D011795:Surveys and Questionnaires