title: Self-reported depressive symptoms and memory complaints in survivors five years after ARDS.
abstract: BACKGROUND
  Survivors of ARDS report depressive symptoms and memory complaints, the prevalence of which after 5 years is unknown.
  
  
  METHODS
  We administered instruments assessing symptoms of depression (Beck Depression Inventory II [BDI-II]) and memory complaints (Memory Assessment Clinics Self-Rating Scale [MAC-S]) to 64 survivors of ARDS from four university-affiliated ICUs 5 years after ICU discharge. We compared BDI-II scores to quality of life (Medical Outcomes Study 36-Item Short Form [SF-36]) mental health domains (role emotional, mental health, mental component summary), compared BDI-II and MAC-S scores to earlier scores (median, 22 months postdischarge), and examined return to work.
  
  
  RESULTS
  Forty-three (67.2%), 46 (71.9%), and 38 (59.4%) patients fully completed the BDI-II, MAC-S ability subscale, and MAC-S frequency of occurrence subscale, respectively. Responders were young (median, 48 years; first-third quartile [Q1-Q3], 39-61 years) with high illness severity. The median BDI-II score was 10 (Q1-Q3, 3-18); eight of 43 (18.6%) had moderate to severe depressive symptoms compared with 14 of 43 (32.6%) earlier (P = .15, n = 38 with paired data). Median MAC-S ability and MAC-S frequency scores were 81 (Q1-Q3, 57-92) and 91.5 (Q1-Q3, 76-105), respectively, similar to earlier scores (P = .67 and P = .64, respectively); 0% to 4.3% scored > 2 SDs below population norms. Higher BDI-II score was predicted by higher earlier BDI-II score, slower recovery of organ function, and longer duration of mechanical ventilation and ICU stay. Higher MAC-S score was predicted by higher earlier MAC-S score. SF-36 mental health domain scores were very stable (P = .57-.83). BDI-II and SF-36 mental health domains were negatively correlated (Spearman coefficient, -0.50 to -0.82). Most patients returned to work regardless of depressive symptoms (minimal to mild, 31 of 35 [88.6%]; moderate to severe, five of eight [62.5%]; P = .12).
  
  
  CONCLUSIONS
  Compared with ∼ 2 years postdischarge from the ICU, depressive symptoms and memory complaints were similar at 5 years. Mental health domains of the SF-36 may not be sensitive to small changes in mood symptoms.
authors: Interdepartmental Division of Critical Care, University of Toronto, Toronto; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto. Electronic address: neill.adhikari@utoronto.ca.
authors: Neill K J
authors: NKJ
authors: Adhikari
authors: Department of Medicine, University Health Network, Toronto.
authors: Catherine M
authors: CM
authors: Tansey
authors: Krembil Neuroscience Centre, University Health Network, Toronto.
authors: Mary Pat
authors: MP
authors: McAndrews
authors: Department of Medicine, University Health Network, Toronto.
authors: Andrea
authors: A
authors: Matté
authors: Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto.
authors: Ruxandra
authors: R
authors: Pinto
authors: Department of Medicine, University Health Network, Toronto; Women's Health Program, University Health Network, Toronto; Department of Medicine, University of Toronto, Toronto; Department of Health Policy, Management and Evaluation and the Dalla Lana School of Public Health, University of Toronto, Toronto.
authors: Angela M
authors: AM
authors: Cheung
authors: Women's Health Program, University Health Network, Toronto; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors: Natalia
authors: N
authors: Diaz-Granados
authors: Interdepartmental Division of Critical Care, University of Toronto, Toronto; Department of Medicine, University Health Network, Toronto; Department of Medicine, University of Toronto, Toronto.
authors: Margaret S
authors: MS
authors: Herridge
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D059026:Diagnostic Self Evaluation; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D016014:Linear Models; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D009864:Ontario; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D012737:Sex Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors