Self-reported symptoms of depression and memory dysfunction in survivors of ARDS.
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.
Adhikari
Neill K J
NKJ
Interdepartmental Division of Critical Care and Department of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: neill.adhikari@utoronto.ca.
McAndrews
Mary Pat
MP
Krembil Neuroscience Program, University Health Network, Toronto, ON, Canada.
Tansey
Catherine M
CM
Medical-Surgical Intensive Care Unit, University Health Network, Toronto, ON, Canada.
Matté
Andrea
A
Medical-Surgical Intensive Care Unit, University Health Network, Toronto, ON, Canada.
Pinto
Ruxandra
R
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Cheung
Angela M
AM
Department of Medicine, University of Toronto, Toronto, ON, Canada.
Diaz-Granados
Natalia
N
Women's Health Program, University Health Network, Toronto, ON, Canada.
Barr
Aiala
A
Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada.
Herridge
Margaret S
MS
Interdepartmental Division of Critical Care and Department of Medicine, University of Toronto, Toronto, ON, Canada.
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