@article{31874,
  keywords = {Neglected tropical diseases (NTDs), Psychological aspects, Snakebite envenoming},
  author = {Wijesinghe C and Williams SS and Kasturiratne A and Dolawaththa N and Wimalaratne P and Wijewickrema B and Jayamanne SF and Isbister G and Dawson A and Lalloo D and Silva JH},
  title = {A randomized controlled trial of a brief intervention for delayed psychological effects in snakebite victims.},
  abstract = {<p><strong>BACKGROUND: </strong>Snakebite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims.</p>

<p><strong>AIM: </strong>To assess the effectiveness of a brief intervention which can be provided by non-specialist doctors aimed at reducing psychological morbidity following snakebite envenoming.</p>

<p><strong>METHOD: </strong>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.</p>

<p><strong>RESULTS: </strong>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.</p>

<p><strong>CONCLUSIONS: </strong>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.</p>
},
  year = {2015},
  journal = {PLoS neglected tropical diseases},
  volume = {9},
  pages = {e0003989},
  issn = {1935-2735},
  url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532481/pdf/pntd.0003989.pdf},
  doi = {10.1371/journal.pntd.0003989},
  language = {eng},
}