Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study
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...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-01-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472420001696/type/journal_article |
| _version_ | 1827995615843319808 |
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| author | Natasa Basrak Naoise Mulcrone Sue Sharifuddin Zeshan Ghumman Nirvana Bechan Enas Mohamed Michael Murray Hariharan Rajendran Sean Gunnigle Mark Nolan Tim Quane Masashi Terao Tracey Hoare Kevin Kirrane Harry G. Kennedy Mary Davoren |
| author_facet | Natasa Basrak Naoise Mulcrone Sue Sharifuddin Zeshan Ghumman Nirvana Bechan Enas Mohamed Michael Murray Hariharan Rajendran Sean Gunnigle Mark Nolan Tim Quane Masashi Terao Tracey Hoare Kevin Kirrane Harry G. Kennedy Mary Davoren |
| author_sort | Natasa Basrak |
| collection | DOAJ |
| description | 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.
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| first_indexed | 2024-04-10T04:59:06Z |
| format | Article |
| id | doaj.art-609407ac928a4b899ea52685693227df |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:06Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-609407ac928a4b899ea52685693227df2023-03-09T12:29:06ZengCambridge University PressBJPsych Open2056-47242021-01-01710.1192/bjo.2020.169Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort studyNatasa Basrak0Naoise Mulcrone1Sue Sharifuddin2Zeshan Ghumman3Nirvana Bechan4Enas Mohamed5Michael Murray6Hariharan Rajendran7Sean Gunnigle8Mark Nolan9Tim Quane10Masashi Terao11Tracey Hoare12Kevin Kirrane13Harry G. Kennedy14https://orcid.org/0000-0003-3174-3272Mary Davoren15https://orcid.org/0000-0002-8054-298XNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, Ireland; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital, Dublin; and DUNDRUM Centre for Forensic Excellence, Trinity College Dublin, IrelandBackground 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. https://www.cambridge.org/core/product/identifier/S2056472420001696/type/journal_articleCOVID-19schizophreniaforensic mental health servicesrisk assessmentobesity |
| spellingShingle | Natasa Basrak Naoise Mulcrone Sue Sharifuddin Zeshan Ghumman Nirvana Bechan Enas Mohamed Michael Murray Hariharan Rajendran Sean Gunnigle Mark Nolan Tim Quane Masashi Terao Tracey Hoare Kevin Kirrane Harry G. Kennedy Mary Davoren Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study BJPsych Open COVID-19 schizophrenia forensic mental health services risk assessment obesity |
| title | Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study |
| title_full | Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study |
| title_fullStr | Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study |
| title_full_unstemmed | Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study |
| title_short | Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study |
| title_sort | risk of adverse outcome of covid 19 among patients in secure psychiatric services observational cohort study |
| topic | COVID-19 schizophrenia forensic mental health services risk assessment obesity |
| url | https://www.cambridge.org/core/product/identifier/S2056472420001696/type/journal_article |
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