Rees Cheryl, Thomson Lindsay
Division of Psychiatry, University of Edinburgh, UK.
Forensic Psychiatry, University of Edinburgh; The State Hospital, Scotland; and The Forensic Mental Health Managed Care Network, Scotland, UK.
BJPsych Open. 2020 Jun 18;6(4):e62. doi: 10.1192/bjo.2020.40.
Premature mortality among patients experiencing forensic care is high. This paper examines the morbidity and mortality of all Scottish high secure patients in 1992/1993 and followed up 20 years later through the context of recovery.
To explore morbidity and delineate which patients are at greatest risk of premature mortality. To assess the extent of suicide and unnatural deaths. To establish which factors, if any, appear protective.
Health and mortality data were extracted from national data-sets and death categorised as premature or post-expected age. Standardised mortality ratios were calculated to explore natural, unnatural and suicide deaths with Cox regression conducted to explore baseline demographics and premature death.
During a mean follow-up of 21.1 years, 36.9% (n = 89) died, at an average age of 55.6 years. Of these, 70.8% (n = 63) died prematurely. Men lost on average 14.9 years and women 24.1 years of potential life. Five lives (5.6%) were lost by suicide and three (3.4%) by unnatural means.
In contrast to other mainstream and forensic cohorts, high rates of suicide and accidental deaths were not apparent. Risk of premature mortality is high. A greater focus upon physical health by community and in-patient services is essential.
接受法医护理的患者过早死亡率很高。本文研究了1992/1993年所有苏格兰高度戒备患者的发病率和死亡率，并在20年后通过康复背景进行了随访。
探讨发病率，确定哪些患者过早死亡风险最高。评估自杀和非自然死亡的程度。确定是否有任何因素具有保护作用。
从国家数据集提取健康和死亡率数据，并将死亡分类为过早死亡或超过预期年龄死亡。计算标准化死亡率以探讨自然、非自然和自杀死亡情况，并进行Cox回归以探讨基线人口统计学和过早死亡情况。
在平均21.1年的随访期间，36.9%（n = 89）的患者死亡，平均年龄为55.6岁。其中，70.8%（n = 63）过早死亡。男性平均损失14.9年潜在寿命，女性平均损失24.1年潜在寿命。5例（5.6%）死于自杀，3例（3.4%）死于非自然原因。
与其他主流和法医队列不同，自杀和意外死亡的高发生率并不明显。过早死亡风险很高。社区和住院服务必须更加关注身体健康。
