Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study.

Autor: Basrak N; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Mulcrone N; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Sharifuddin S; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Ghumman Z; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Bechan N; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Mohamed E; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Murray M; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Rajendran H; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Gunnigle S; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Nolan M; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, Ireland., Quane T; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Terao M; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Hoare T; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Kirrane K; National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland., Kennedy HG; National Forensic Mental Health Service, Central Mental Hospital, Dublin; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, Ireland., Davoren M; National Forensic Mental Health Service, Central Mental Hospital, Dublin; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, Ireland.
Jazyk: angličtina
Zdroj: BJPsych open [BJPsych Open] 2021 Jan 11; Vol. 7 (1), pp. e31. Date of Electronic Publication: 2021 Jan 11.
DOI: 10.1192/bjo.2020.169
Abstrakt: Background: Secure forensic mental health services treat patients with high rates of treatment-resistant psychoses. High rates of obesity and medical comorbidities are common. Population-based studies have identified high-risk groups in the event of SARS-CoV-2 infection, including those with problems such as obesity, lung disease and immune-compromising conditions. Structured assessment tools exist to ascertain the risk of adverse outcome in the event of SARS-CoV-2 infection.
Aims: To assess risk of adverse outcome in the event of SARS-CoV-2 infection in a complete population of forensic psychiatry patients using structured assessment tools.
Method: All patients of a national forensic mental health service (n = 141) were rated for risk of adverse outcome in the event of SARS-CoV-2 infection, using two structured tools, the COVID-Age tool and the COVID-Risk tool.
Results: We found high rates of relevant physical comorbidities. Mean chronological age was 45.5 years (s.d. = 11.4, median 44.1), mean score on the COVID-Age tool was 59.1 years (s.d. = 19.4, median 58.0), mean difference was 13.6 years (s.d. = 15.6), paired t = 10.9, d.f. = 140, P < 0.001. Three patients (2.1%) were chronologically over 70 years of age, compared with 43 (30.5%) with a COVID-Age over 70 (χ2 = 6.99, d.f. = 1, P = 0.008, Fisher's exact test P = 0.027).
Conclusions: Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population-based guidance on self-isolation and other precautions based on chronological age may not be sufficient. There is an urgent need for better physical health research and treatment in this group.
Databáze: MEDLINE
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