Acute and Delayed Stress Symptoms Following Snakebite

Overwhelming life experiences can trigger stress disorders including acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). The objective of this study was to investigate the frequency of and predictive factors for ASD and PTSD in snakebite victims. In this study, snakebite victims who were admitted to Mashhad Medical Toxicology Centre, Imam Reza Hospital, Iran, from 1st November 2010 to 30th April 2012 were enrolled. Psychiatric symptoms of patients were evaluated after stabilization of patients’ clinical condition. Structured Clinical Interview for DSM-IV Axis I Disorder questionnaire was used for interviewing the patients. Patients underwent 4 scheduled psychiatric interviews on admission, 3 weeks post-bite, 6 weeks post-bite and 6 months post-bite. Fifty-three patients (74% men) were included in the study with mean (SD) age of 33.6 (15.0) years. Patients were given psychological consultations during the study while they received no psychiatric medication. The set of efforts to avoid activities, places, or people that arouse recollections of the trauma was the most common symptom found in all visits. Re-experience was the most common class of symptoms in all visits. On admission and the 3rd week post-bite, 36% and 15% of patients had ASD. Moreover, 8% of patients developed PTSD and only 4% of patients developed chronic PTSD. ASD on admission (P < 0.001), ASD in 3rd week (P = 0.02) and PTSD (P = 0.01) were developed in patients with significantly younger ages. In addition, the presence of ASD on admission (P < 0.001), ASD in 3rd week (P = 0.003) and PTSD (P = 0.003) was significantly higher in female gender. Snakebite is not only an emergency medical problem, but also is a traumatic event that can cause stress disorders. It is prudent to refer all snakebite victims, especially women in younger ages, to psychiatric specialist for better evaluation and psychological treatments.