Around 20 percent of former intensive care patients develop more or less severe symptoms of PTSD, such as flashbacks, insomnia and nightmares, in the first twelve months after being discharged from an intensive care unit. Many seek support from their general practitioner - or are approached there for the first time about the psychological consequences. However, specialized psychotherapy is often difficult to access. This is where the concept developed by the Munich team comes in.
The intervention is based on narrative exposure therapy (NET), a structured conversation technique for processing traumatic experiences. The LMU researchers have developed the shortest possible NET variant for GP practices: three individual sessions of 30-45 minutes each plus seven telephone follow-up contacts by medical assistants.
In the controlled study with 319 patients, 160 of whom received the new intervention (three individual sessions) and 159 of whom received standard care from their GP, the method showed clear advantages: The number and intensity of flashbacks decreased and feelings of guilt diminished. Avoidance behavior, i.e. avoiding threatening situations, and overexcitability were less affected, but the patients' mood was. After one year, the positive effects were still detectable, but had weakened.
The intervention is easy and quick to learn for GPs, who have a great deal of prior knowledge, and can be incorporated into everyday practice. The feedback from the participating GPs and patients was consistently positive. A promising approach for general practice - and for an often overlooked patient group.
Original publication:
Effects of a general practitioner-led brief narrative exposure intervention on symptoms of post-traumatic stress disorder after intensive care (PICTURE): multicentre, observer blind, randomized controlled trial
doi: https://doi.org/10.1136/bmj-2024-082092
