McKinnon Iain, Lewis Thomas, Mehta Naomi, Imrit Shahed, Thorp Julie, Ince Chris
Secure Services,Northumberland Tyne and Wear NHS Foundation Trust,UK.
Older People's Community Treatment Team,Northumberland Tyne and Wear NHS Foundation Trust,UK.
BJPsych Bull. 2018 Feb;42(1):24-29. doi: 10.1192/bjb.2017.8.
Aims and method To assess the benefits of the introduction of routine vitamin D serum sampling for all patients admitted to a secure in-patient hospital in the North of England providing medium security, low security and rehabilitation services for offenders with intellectual and developmental disability. The vitamin D levels of 100 patients were analysed at baseline. Those with insufficient or deficient levels were offered treatment and retested after 1 year. Vitamin D levels were analysed in the context of level of security, seasonality of test and co-prescription of psychotropic medications.
Eighty-three per cent of patients had suboptimal vitamin D levels at initial test (41% deficient and 42% insufficient). This was seen among established patients and new admissions. Regression analysis of baseline vitamin D levels revealed no differences for levels of security, seasonality, whether patients were taking antipsychotic or anticonvulsant medication, or length of stay. Patients with deficiency or insufficiency were all offered supplementation. Those who opted in had significantly higher vitamin D levels at follow-up, compared with those who declined treatment. Clinical implications Established and newly admitted patients in our secure mental health services had substantial levels of vitamin D insufficiency. In the light of the morbidities that are associated with deficient vitamin D levels, routine screening and the offer of supplementation is advisable. Declaration of interest None.
目的与方法 为评估对入住英格兰北部一家为患有智力和发育障碍的罪犯提供中度安全、低度安全和康复服务的安全住院医院的所有患者进行常规维生素D血清采样的益处。对100名患者的维生素D水平进行了基线分析。维生素D水平不足或缺乏的患者接受治疗,并在1年后重新检测。在安全级别、检测的季节性以及精神药物的联合处方背景下分析维生素D水平。
83%的患者在初次检测时维生素D水平欠佳(41%缺乏,42%不足)。在长期住院患者和新入院患者中均有此情况。对基线维生素D水平的回归分析显示,在安全级别、季节性、患者是否服用抗精神病药物或抗惊厥药物以及住院时间方面没有差异。维生素D缺乏或不足的患者均接受了补充治疗。与拒绝治疗的患者相比,选择接受治疗的患者在随访时维生素D水平显著更高。临床意义 我们安全心理健康服务机构中的长期住院患者和新入院患者维生素D不足的情况较为严重。鉴于与维生素D水平缺乏相关的疾病,建议进行常规筛查并提供补充治疗。利益声明 无。