Depression & PTSD in snakebite survivors: need for more research

Snakebite is a neglected tropical disease that causes death and disability, particularly in rural and tribal people in South Asia, Africa and Latin America. Death, permanent disabilities and long-term physical sequalae due to snakebite has been much discussed and talked about. But are there any mental health manifestation in snakebite survivors?

Keen to understand this better, I got together with other colleagues from the George Institute of Global Health, India to conduct a global review of existing research evidence on the same. The idea was to get information on all we know about mental health in snakebite survivors – its epidemiology, risk factors, burden estimates, or anything around its prevention or management. Hence, we chose a scoping review approach of evidence synthesis.

 Through our research, published recently in BMJ Global Health, we found that there is not much understood with only a handful of papers on the same (including case reports). We found that studies have reported post-traumatic stress disorder (PTSD) and depression in 8% to 43% and 25% to 54% of snakebite survivors, respectively. There was only one study modelling the DALYs lost due to mental health conditions in sub-Saharan Africa and only one randomized controlled trial on the issue.  

Our research clearly shows that depression and PTSD are major causes of morbidity in, but it remains understudied and underexplored globally, including in India and Pakistan, which has the highest burden of snakebite (amounting to  almost half of the global snakebite deaths). There are studies from northern Bangladesh and Sri Lanka but none from these countries in South Asia with high burden. In general, mental health professionals are scarce in countries with high burden of snakebite. This implies apart from understanding the burden and risk factors of mental health manifestations of snakebite, there is also a need for research to understand how this can be dealt by resource-strained health systems. Screening tools for mental health conditions in snakebite patients, particularly those which can be used in primary care are an important which need to be researched on. There is a need for more research on understanding the neglected aspect of morbidity of snakebite.

About the author: Soumyadeep Bhaumik is a medical doctor and international public health specialist working in The George Institute for Global Health. He is the National Convenor of the Snakebite Research Network. Views are personal and might not necessarily be subscribed to author’s institution, funders or the Snakebite Research Network .

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