Effects of a brief primary care intervention for post-traumatic stress disorder symptoms after critical illness on health-related quality of life - A secondary analysis of the PICTURE randomised controlled trial.

Authors

Robert Philipp Kosilek, Nora Schröder, Linda Sanftenberg, Caroline Jung-Sievers, Daniela Lindemann, Antina Beutel, Konrad Schmidt, Christian Brettschneider, Hans-Helmut König, Thomas Elbert, Jochen Gensichen

Published in

The European journal of general practice. Volume 32. Issue 1. Pages 2702686. Epub Jul 21, 2026.

Abstract

Intensive care unit (ICU) survivors frequently experience symptoms of post-traumatic stress disorder (PTSD) and reduced health-related quality of life (HRQoL), yet evidence for effective post-ICU interventions in primary care remains limited. This secondary analysis of the PICTURE randomised controlled trial provides an in-depth evaluation of HRQoL trajectories and potential treatment mechanisms.
The analysis included 319 adult ICU survivors with at least moderate PTSD symptoms, randomised to a brief general practitioner (GP)-delivered narrative exposure intervention or enhanced usual care. Longitudinal mixed-effects models estimated treatment-by-time effects on HRQoL, based on EuroQol Five-Dimension Five-Level (EQ-5D-5L) index and visual analog scale (VAS), with mediation via PTSD symptom change assessed using structural equation modelling.
The mean baseline EQ index was 0.71 ± 0.27 and EQ VAS was 60.7 ± 19.4. Mixed-effects models showed a transient improvement in EQ VAS at 6 months in the intervention group (ß = 5.85; 95% CI 0.84-10.87), followed by a delayed improvement in the EQ index at 12 months (ß = 0.075; 95% CI 0.014-0.136). About one quarter of the 12-month EQ index effect was mediated by PTSD symptom reduction at 6 months. Domain-level analyses indicated greater improvement in anxiety/depression and mobility.
In ICU survivors with PTSD symptoms, a brief GP-delivered psychological intervention was associated with clinically meaningful improvements in health-related quality of life over 12 months, with effects emerging over time and only partly explained by PTSD symptom reduction.
ClinTrials.gov: NCT03315390 (Registration date: 2017-10-20); German Clinical Trials Register (DRKS): DRKS00012589 (Registration date: 2017-10-17).

PMID:
42480006
Bibliographic data and abstract were imported from PubMed on 22 Jul 2026.

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