GP-led therapies reduce PTSD symptoms in critically ill patients

A recent study has shown that talking therapies led by general practitioners (GPs) can help reduce post-traumatic stress disorder (PTSD) symptoms in critically ill patients. Conducted across various GP practices in Germany, the trial involved 319 adults who experienced critical illnesses. It revealed that structured GP interventions can alleviate PTSD symptoms effectively.

The findings, published in the BMJ, highlighted the potential of GP consultations to fill the gap between a patient’s discharge from intensive care units (ICU) and their access to specialized mental health services. Approximately 20% of ICU patients develop PTSD, yet they often face long waiting times for mental health support. Most aftercare for these patients is provided through primary care, where services specifically targeting PTSD are limited.

In the trial, participants were divided into two groups. One group received three structured consultations with GPs, followed by eight follow-up interactions with nurses, specifically aimed at addressing PTSD symptoms. The other group received improved usual care, serving as the control group. Both groups began with an average PTSD severity score of 30.6 on the post-traumatic diagnostic scale (PDS-5), which ranges from 0 to 80, with higher scores indicating more severe PTSD.

After six months, the intervention group’s average PDS-5 score decreased by 6.2 points, while the control group’s score dropped by only 1.5 points. At the 12-month mark, the intervention group continued to show improvement, with a score reduction of 7.9 points, compared to a 2.5-point decrease in the control group. Despite these changes, the researchers noted that the differences were below the minimal clinically important threshold of six points, which could be attributed to the brief and low-intensity nature of the interventions.

The study also acknowledged several limitations, including the exclusion of individuals with severe PTSD symptoms, the minimal training provided to GPs, and unmeasured factors that may have influenced the outcomes. Nevertheless, the researchers emphasized the study’s importance in advancing trauma-informed care within primary settings. They remarked that given the prevalence of PTSD symptoms following critical illnesses and the existing wait times for mental health specialists, this GP-led intervention could be both practical and beneficial.

The researchers clarified that this model should not replace psychiatric treatment but could offer a valuable support system to lessen the psychological burden associated with critical illnesses. They called for future research to focus on refining therapy content, optimizing care delivery, and ensuring integration across healthcare systems.