Psychological consequences after intensive care: New therapy brings hope!

Psychological consequences after intensive care: New therapy brings hope!

On May 21, 2025, Prof. Konrad Schmidt, Director of the Institute of General Medicine at the MHB, drew attention to the serious psychological consequences that intensive care unit stays can have. Around a fifth of patients suffer from post-traumatic stress disorder (PTSD) months or even years after their discharge. Given that there are over two million intensive care treatment cases in Germany every year, this represents a significant number of those affected. Many of these patients are further treated in general practitioners' practices after their discharge, although there is a lack of concepts for diagnostics and therapy in general practitioner care, such as MHB Fontane reported.

What is particularly worrying is that most of those affected do not address their complaints and have to accept long waiting times for specialized trauma therapies. The PICTURE study was launched to close this gap in care. This is a study that began on October 21, 2018 and evaluated the effectiveness of a short form of “narrative talk therapy (NET)” for general practitioners.

The PICTURE study

The PICTURE study aims to improve the treatment of patients with PTSD after intensive care stays. The study procedure includes verification of the PTSD diagnosis three months after discharge from the intensive care unit. A total of 319 patients were included in the study and randomized into two groups: a treatment group and a control group. The treatment group received three 45-minute therapy sessions within six weeks, while the control group received standard therapy based on the symptoms. This methodology was developed in DRKS documented in detail.

The course of therapy included the creation of a lifeline of the most intense experiences, a detailed treatment of the experience in the intensive care unit and the processing of another life event. Six months after the last session, it was found that the participants' complaints had been significantly reduced. Prof. Schmidt is joint first author of the results published in the high-ranking journal “British Medical Journal”.

Therapeutic approaches and challenges

Narrative exposure therapy (NET), which was used in the study, is a promising approach to managing PTSD. NET aims to organize memories and feelings in time to promote emotional processing. This method is particularly important because early and comprehensive treatment by psychiatrists is considered crucial to overcoming PTSD. Treatment is usually carried out on an outpatient basis, although clinical stays may also be necessary in severe cases. The central therapy methods include trauma-focused psychotherapy and medication support, as shown on Neurologists and psychiatrists online explained.

Some of the main goals of PTSD treatment are controlling unwanted memories, reducing accompanying symptoms such as anxiety and depression, and integrating the trauma into the patient's life story. It is therefore crucial that timely therapy is implemented in medical practices in order to sustainably improve mental health care. Brandenburg family doctors, like Stefan Höhne, have already benefited from the shortened NET, which illustrates the similarity of the approaches and their implementation in family doctor care.

Overall, the PICTURE study shows how important it is to explore new approaches to traumatic aftercare in order to effectively support patients with PTSD after intensive care treatments. The progress made could help significantly improve mental health care.