Basrak Natasa, Mulcrone Naoise, Sharifuddin Sue, Ghumman Zeshan, Bechan Nirvana, Mohamed Enas, Murray Michael, Rajendran Hariharan, Gunnigle Sean, Nolan Mark, Quane Tim, Terao Masashi, Hoare Tracey, Kirrane Kevin, Kennedy Harry G, Davoren Mary
National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland.
National Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, Ireland.
BJPsych Open. 2021 Jan 11;7(1):e31. doi: 10.1192/bjo.2020.169.
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.
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.
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.
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).
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.
安全的法医精神卫生服务机构治疗难治性精神病患者的比例很高。肥胖率和合并症发病率普遍较高。基于人群的研究已经确定了感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）时的高危人群，包括那些有肥胖、肺部疾病和免疫功能低下等问题的人群。存在结构化评估工具来确定感染SARS-CoV-2时出现不良后果的风险。
使用结构化评估工具评估法医精神病患者全人群感染SARS-CoV-2时出现不良后果的风险。
使用两种结构化工具，即COVID-Age工具和COVID-Risk工具，对一家国家法医精神卫生服务机构的所有患者（n = 141）进行感染SARS-CoV-2时出现不良后果的风险评估。
我们发现相关身体合并症的发生率很高。实际年龄的平均值为45.5岁（标准差 = 11.4，中位数44.1），COVID-Age工具的平均得分是59.1岁（标准差 = 19.4，中位数58.0），平均差异为13.6岁（标准差 = 15.6），配对t检验t = 10.9，自由度 = 140，P < 0.001。实际年龄超过70岁的患者有3名（2.1%），而COVID-Age超过70岁的患者有43名（30.5%）（χ2 = 6.99，自由度 = 1，P = 0.008，Fisher精确检验P = 0.027）。
安全的法医精神科服务机构中的患者是感染SARS-CoV-2时出现不良后果的高危人群。基于实际年龄的关于自我隔离和其他预防措施的人群指导可能不够充分。迫切需要对该群体进行更好的身体健康研究和治疗。
