- Title
- A randomized controlled trial of a brief intervention for delayed psychological effects in snakebite victims
- Creator
- Wijesinghe, Chamara A.; Williams, Shehan S.; de Silva, H. Janaka; Kasturiratne, Anuradhani; Dolawaththa, Nishantha; Wimalaratne, Piyal; Wijewickrema, Buddhika; Jayamanne, Shaluka F.; Isbister, Geoffrey K.; Dawson, Andrew H.; Lalloo, David G.
- Relation
- PLoS Neglected Tropical Diseases Vol. 9, Issue 8, p. 1-12
- Publisher Link
- http://dx.doi.org/10.1371/journal.pntd.0003989
- Publisher
- Public Library of Science
- Resource Type
- journal article
- Date
- 2015
- Description
- 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.
- Subject
- randomized controlled trial; snakebite; psychological morbidity; negative psycho-social impact
- Identifier
- http://hdl.handle.net/1959.13/1305215
- Identifier
- uon:21003
- Identifier
- ISSN:1935-2735
- Language
- eng
- Full Text
- Reviewed
- Hits: 13985
- Visitors: 14285
- Downloads: 451
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 300 KB | Adobe Acrobat PDF | View Details Download |