Functional disability after critical illness in patients with post-traumatic stress disorder symptoms in primary care: A secondary analysis of the PICTURE randomized controlled trial.
Robert Philipp Kosilek, Nora Schröder, Linda Sanftenberg et al.
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In 30 seconds
This secondary analysis of the PICTURE randomized controlled trial examined disability in 319 adults with PTSD symptoms at least 3 months after ICU discharge and assessed change after brief GP-led trauma-focused care versus improved usual care. Depressive and anxiety symptoms were the strongest correlates of baseline disability, more strongly associated than ICU-related factors. There was no meaningful between-group difference at 6 months; by 12 months, disability had declined more in the intervention group (adjusted β = -4.31, 95% CI -8.25 to -0.37).
Key findings
- Depressive and anxiety symptoms were the strongest correlates of baseline disability, exceeding associations with ICU-related factors.
- Emotional difficulties predominated at lower disability levels, while higher disability involved progressively broader impairments.
- No meaningful between-group difference was observed at 6 months; at 12 months, disability declined more with intervention (adjusted β = -4.31, 95% CI -8.25 to -0.37).
- Exploratory analyses suggested greatest improvement in emotional distress, friendships, and work-related activities.
Why it matters
The findings highlight the importance of psychological symptoms in understanding functional disability during post-ICU recovery. They also suggest that functional change after brief trauma-focused care may take time to become apparent, with improvements extending beyond emotional distress to social and work-related domains.
What to keep in mind
This was a secondary analysis, and the item-level findings were exploratory. The reported between-group benefit was evident at 12 months but not at 6 months.