Randomized controlled trial of a brief intervention for delayed psychological effects in snake bite victims

Abstract

Snake bite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. The aim of this study was to assess the effectiveness of a brief intervention which can be provided by non-specialist doctors, and aimed at reducing psychological morbidity following snake bite envenoming. In a single blind, randomized controlled trial, 225 snake bite victims with systemic envenoming were randomized into three arms. One arm received no intervention (Group A, n=68); the second received psychological first aid and psychoeducation at discharge from hospital (Group B, n = 65); while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later (Group C, n = 69). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning. A statistically significant decreasing trend in the proportion of patients positive for psychiatric symptoms of depression and anxiety was observed at six month follow up, from Group A through Group B to Group C, mainly due to a decreasing trend for symptoms of anxiety. There was also significant decreasing trend in the overall prevalence of disability from Group A through Group B to Group C, predominantly in relation to disability in family life and social life.