IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0003989.html
   My bibliography  Save this article

A Randomized Controlled Trial of a Brief Intervention for Delayed Psychological Effects in Snakebite Victims

Author

Listed:
  • Chamara A Wijesinghe
  • Shehan S Williams
  • Anuradhani Kasturiratne
  • Nishantha Dolawaththa
  • Piyal Wimalaratne
  • Buddhika Wijewickrema
  • Shaluka F Jayamanne
  • Geoffrey K Isbister
  • Andrew H Dawson
  • David G Lalloo
  • H Janaka de Silva

Abstract

Background: Snakebite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. Aim: To assess the effectiveness of a brief intervention which can be provided by non-specialist doctors aimed at reducing psychological morbidity following snakebite envenoming. Method: In a single blind, randomized controlled trial, snakebite victims with systemic envenoming [n = 225, 168 males, mean age 42.1 (SD 12.4) years] were randomized into three arms. One arm received no intervention (n = 68, Group A), the second received psychological first aid and psychoeducation (dispelling prevalent cultural beliefs related to snakebite which promote development of a sick role) at discharge from hospital (n = 65, Group B), while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later based on cognitive behavioural principles (n = 69, Group C). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning using standardized tools. Results: At six months, there was a decreasing trend in the proportion of patients who were positive for psychiatric symptoms of depression and anxiety from Group A through Group B to Group C (Chi square test for trend = 7.901, p = 0.005). This was mainly due to a decreasing trend for symptoms of anxiety (chi-square for trend = 11.256, p = 0.001). There was also decreasing trend in the overall prevalence of disability from Group A through Group B to Group C (chi square for trend = 7.551, p = 0.006), predominantly in relation to disability in family life (p = 0.006) and social life (p = 0.005). However, there was no difference in the proportion of patients diagnosed with depression between the three groups (chi square for trend = 0.391, p = 0.532), and the intervention also had no effect on post-traumatic stress disorder. Conclusions: A brief psychological intervention, which included psychological first aid and psychoeducation plus cognitive behavioural therapy that can be provided by non-specialist doctors appeared to reduce psychiatric symptoms and disability after snakebite envenoming, but not depression or post-traumatic stress disorder. Trial Registration: Sri Lanka Clinical Trials Registry: SLCTR/2011/003 Author Summary: Snakebite is an important health problem in many rural communities in tropical countries. However, little is known about the lasting physical and mental health effects following a bite. We recently reported that mental problems, with harmful social outcomes, can occur in many people after they are bitten by a snake. As the affected are often poor farmers or manual workers, this may affect their livelihoods. We, therefore, performed a trial which looked at the effectiveness of short psychological interventions, lasting about 15 and 20 minutes, which can be provided by even non-specialist doctors, in reducing these mental and social problems in people bitten by snakes. Our results show that such interventions may indeed be helpful to reduce some of these problems, but more research is needed to improve these interventions, especially so that they that can reduce post-traumatic stress disorder and depression after snakebite.

Suggested Citation

  • Chamara A Wijesinghe & Shehan S Williams & Anuradhani Kasturiratne & Nishantha Dolawaththa & Piyal Wimalaratne & Buddhika Wijewickrema & Shaluka F Jayamanne & Geoffrey K Isbister & Andrew H Dawson & D, 2015. "A Randomized Controlled Trial of a Brief Intervention for Delayed Psychological Effects in Snakebite Victims," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 9(8), pages 1-12, August.
  • Handle: RePEc:plo:pntd00:0003989
    DOI: 10.1371/journal.pntd.0003989
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003989
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0003989&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0003989?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Shehan S Williams & Chamara A Wijesinghe & Shaluka F Jayamanne & Nicholas A Buckley & Andrew H Dawson & David G Lalloo & H Janaka de Silva, 2011. "Delayed Psychological Morbidity Associated with Snakebite Envenoming," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 5(8), pages 1-6, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Soumyadeep Bhaumik & Deepti Beri & Zohra S Lassi & Jagnoor Jagnoor, 2020. "Interventions for the management of snakebite envenoming: An overview of systematic reviews," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(10), pages 1-26, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. José María Gutiérrez & Thierry Burnouf & Robert A Harrison & Juan J Calvete & Nicholas Brown & Simon D Jensen & David A Warrell & David J Williams & Global Snakebite Initiative, 2015. "A Call for Incorporating Social Research in the Global Struggle against Snakebite," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 9(9), pages 1-4, September.
    2. Muhammad Hamza & Maryam A Idris & Musa B Maiyaki & Mohammed Lamorde & Jean-Philippe Chippaux & David A Warrell & Andreas Kuznik & Abdulrazaq G Habib, 2016. "Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(3), pages 1-16, March.
    3. Abdulrazaq G Habib & Mohammed Lamorde & Mahmood M Dalhat & Zaiyad G Habib & Andreas Kuznik, 2015. "Cost-effectiveness of Antivenoms for Snakebite Envenoming in Nigeria," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 9(1), pages 1-7, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0003989. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.