Predictors of depression among patients receiving treatment for snakebite in General Hospital, Kaltungo, Gombe State, Nigeria: August 2015

BACKGROUND Snakebite though neglected, affects 5 million people yearly. More neglected is the psychological effect of envenomation. We determined prevalence and pattern of depression among patients admitted into snakebite wards of Kaltungo General Hospital Nigeria, and percentage recognized by clinicians. We also assessed for factors associated with depression. METHODS In a descriptive hospital based study, we used Patient Health questionnaire (PHQ-9) to make diagnosis of depression among the patients. We reviewed patients' clinical records to determine clinicians' recognition of depression. RESULTS Of 187 interviews analyzed, 47 (25%) had depression with none recognized by attending clinicians. Patients with snakebite complications (odd ratio [OR] 3.1, 95% CI 1.1-8.5), and previous history of snakebites (OR 2.7, 95% CI 1.1-6.1) were associated with mild depression. Worrying about family welfare (OR 31.5, 95% CI 6.5-152.9), financial loss (OR 14.6, 95% CI 1.8-121.5) and time loss (OR 14.6, 95% CI 1.8-121.5), past history of snakebites (OR 8.3, 95% CI 1.9-36.5) and lower income (Mean difference -25,069 [84 USD], 95% CI 35,509 [118 USD]-14,630 [49 USD]) were associated with severe depression. CONCLUSION A quarter of in-patients of snakebite wards of the general hospital had comorbid depression that went unrecognized. Independent predictors of depression such as past history of snakebite, worrying about relations and having snakebite complications could help clinicians anticipate depression among patients. We recommend training of clinicians in the hospital on recognition of common psychological disorders like depression.