Trauma after intensive care

Researchers and family doctors from Brandenburg involved in major study

Prof. Konrad Schmidt

Neuruppin, 21 May 2025

Life-saving periods on intensive care units may leave traumatic memories – often associated with lasting mental problems. Frequently such stays are a matter of life or death for sick or injured people. As in other cases of traumatic, life-threatening experiences, about one fifth of affected persons suffer repeated nightmares and seemingly real inner images for months and years: these may be symptoms of post-traumatic stress disorder (PTSD). This memory disorder is accompanied by considerable psychological strain and in many cases further mental problems. More than two million cases of intensive medical treatment per year in Germany constitute a relevant quantity of affected persons.

This significant number raises the question of further treatment. Most patients are discharged from inpatient facilities for further treatment by their general practitioner. At this point there is a lack of concepts for diagnostics and therapy, since many affected persons avoid talking about their problems and face long waiting times for specialized trauma therapy not only in Brandenburg, says Prof. Dr. Konrad Schmidt, director of the Institute of General Medicine at the Brandenburg Medical School Theodor Fontane (MHB).

The PICTURE study might help to close this obvious gap in healthcare. A short version of the so called “Narrative exposure intervention (NET)”, a conversational therapy, was developed specifically for family doctors. The underlying idea is to restore the accurate temporal order of memories and feelings and thus to facilitate emotional processing.

The intervention has been successfully employed in many countries of the global South where only very few specialists are available to large numbers of traumatized people. Prof. Schmidt reports: “The shortened version of NET, workable and randomized-controlled, has been tested in a total of 319 family practices – with satisfactory results. Disorders were still notably reduced six months after the last talking therapy.”

The team of researchers, coordinated by the Ludwig Maximilian University of Munich, recently published their findings in the renowned "British Medical Journal", with one of the highest impact factors (IF 2024=93,6) for MHB publications – which underlines the scientific quality of the paper. Prof. Schmidt (shared first-authorship): "Mental problems are frequently related to traumatic memories, and family doctors are the first point of contact for most people. This simple therapy has therefore a great potential for improved healthcare.”

The MHB was not involved as an official study center; but several general practitioners belonging to the MHB network of research practices participated in the study. One of them is Stefan Höhne from Zehdenick. Here is his assessment: "This is a successful example of how to integrate scientific quality into the frequently hectic day-to-day routines of a family practice. My study participants and myself have definitely profited from the method.”

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, randomised controlled trial“

doi: https://doi.org/10.1136/bmj-2024-082092


Kontakt:
Prof. Dr. Konrad Schmidt
E-Mail: allgemeinmedizin@mhb-fontane.de

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