The George Institute for Global Health, New Delhi, India
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
BMJ Glob Health. 2020 Nov;5(11). doi: 10.1136/bmjgh-2020-004131.
Snakebite is a neglected tropical disease. Snakebite causes at least 120 000 death each year and it is estimated that there are three times as many amputations. Snakebite survivors are known to suffer from long-term physical and psychological sequelae, but not much is known on the mental health manifestations postsnakebite.
We conducted a scoping review and searched five major electronic databases (Ovid MEDLINE(R), Global Health, APA PsycINFO, EMBASE classic+EMBASE, Cochrane Central Register of Controlled Trials), contacted experts and conducted reference screening to identify primary studies on mental health manifestations after snakebite envenomation. Two reviewers independently conducted titles and abstract screening as well as full-text evaluation for final inclusion decision. Disagreements were resolved by consensus. We extracted data as per a standardised form and conducted narrative synthesis.
We retrieved 334 studies and finally included 11 studies that met our eligibility criteria. Of the 11 studies reported, post-traumatic stress disorder (PTSD) was the most commonly studied mental health condition after snakebite, with five studies reporting it. Estimate of the burden of PTSD after snakebite was available from a modelling study. The other mental health conditions reported were focused around depression, psychosocial impairment of survivors after a snakebite envenomation, hysteria, delusional disorders and acute stress disorders.
There is a need for more research on understanding the neglected aspect of psychological morbidity of snakebite envenomation, particularly in countries with high burden. From the limited evidence available, depression and PTSD are major mental health manifestations in snakebite survivors.
蛇咬伤是一种被忽视的热带病。每年至少有 12 万人因此死亡,估计因此截肢的人数是其 3 倍。蛇咬伤幸存者已知会遭受长期的身体和心理后遗症,但对蛇咬伤后心理健康表现知之甚少。
我们进行了范围界定审查,并在五个主要电子数据库(Ovid MEDLINE(R)、全球健康、APA PsycINFO、EMBASE classic+EMBASE、Cochrane 对照试验中心注册)中进行了检索,联系了专家并进行了参考文献筛选,以确定关于蛇咬伤后心理健康表现的主要研究。两名审查员独立进行标题和摘要筛选以及全文评估,以做出最终纳入决定。分歧通过共识解决。我们按照标准表格提取数据并进行叙述性综合。
我们检索到 334 项研究,最终纳入 11 项符合入选标准的研究。在报告的 11 项研究中,创伤后应激障碍(PTSD)是研究蛇咬伤后心理健康状况最常见的疾病,有 5 项研究报告了该病。一项建模研究提供了蛇咬伤后 PTSD 负担的估计。报告的其他心理健康状况包括抑郁、蛇咬伤幸存者的心理社会损害、歇斯底里、妄想障碍和急性应激障碍。
需要更多的研究来了解被忽视的蛇咬伤心理发病率方面,特别是在负担较重的国家。从现有的有限证据来看,抑郁和 PTSD 是蛇咬伤幸存者的主要心理健康表现。