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Title: | A Randomized Controlled Trial of a brief Intervention for delayed psychological effects in snakebite victims |
Authors: | Wijesinghe, C.A. Williams, S.S. Kasturiratne, A. Dolawaththa, N. Wimalaratne, P. Wijewickrema, B. Jayamanne, S.F. Isbister, G.K. Dawson, A.H. Lalloo, D.G. de Silva, H.J. |
Keywords: | Snake Bites Snake Bites-psychology Snake Bites-therapy Psychotherapy-methods Stress Disorders, Post-Traumatic Stress Disorders, Post-Traumatic-therapy Treatment Outcome Cognitive Behavioral Therapy Depressive Disorder-therapy Randomized Controlled Trial |
Issue Date: | 2015 |
Publisher: | Public Library of Science |
Citation: | PLoS Neglected Tropical Diseases. 2015;9(8):e0003989 |
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. |
Description: | Indexed in MEDLINE |
URI: | http://repository.kln.ac.lk/handle/123456789/9289 |
ISSN: | 1935-2735 (Electronic) 1935-2727 (Print) |
Appears in Collections: | Journal/Magazine Articles |
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wijesinghe.2015.pdf | 270.03 kB | Adobe PDF | View/Open |
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