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Chest. 2011 Dec;140(6):1484-1493. doi: 10.1378/chest.11-1667. Epub 2011 Oct 13.

Self-reported depressive symptoms and memory complaints in survivors five years after ARDS.

Author information

1
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.
2
Department of Medicine, University Health Network, Toronto.
3
Krembil Neuroscience Centre, University Health Network, Toronto.
4
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto.
5
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.
6
Women's Health Program, University Health Network, Toronto; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
7
Interdepartmental Division of Critical Care, University of Toronto, Toronto; Department of Medicine, University Health Network, Toronto; Department of Medicine, University of Toronto, Toronto.

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.

PMID:
21998261
DOI:
10.1378/chest.11-1667
[Indexed for MEDLINE]

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