COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services
Introduction Secure forensic mental health services treat patient with high rates of treatment resistant psychoses, typically schizophrenia. These groups have high rates of obesity and medical co-morbidities. Population based studies have identified high risk groups in the event of SARS-CoV-2 infe...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382101004X/type/journal_article |
| _version_ | 1797617174356951040 |
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| author | N. Basrak N. Mulcrone S. Sharifuddin Z. Ghumman N. Bechan E. Mohamed M. Murray H. Rajendran S. Gunnigle M. Nolan T. Quane M. Terao T. Hoare K. Kirrane H. Kennedy M. Davoren |
| author_facet | N. Basrak N. Mulcrone S. Sharifuddin Z. Ghumman N. Bechan E. Mohamed M. Murray H. Rajendran S. Gunnigle M. Nolan T. Quane M. Terao T. Hoare K. Kirrane H. Kennedy M. Davoren |
| author_sort | N. Basrak |
| collection | DOAJ |
| description |
Introduction
Secure forensic mental health services treat patient with high rates of treatment resistant psychoses, typically schizophrenia. These groups have high rates of obesity and medical co-morbidities. Population based studies have identified high risk groups in the event of SARS-CoV-2 infection, including those with long term medical conditions.
Objectives
The aim of this study was to compare the vulnerability to serious adverse outcome in the event of COVID-19 infection in a forensic psychiatric patient population.
Methods
All patients of a complete 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
Eighty-two patients (58.2%) met criteria for obesity, 32 had type II diabetes and 28 were hypertensive. Mean chronological age was 45.5 years (SD 11.4, median 44.1), while mean COVID-AGE was 59.1 years (SD 19.4, median 58.0), mean difference 13.6 years (SD 15.6) paired t=10.9, df=140, p=0.000. Three patients (2.1%) were chronologically over 70 years compared to 40 (28.4%) with a COVID-AGE over 70 (X2=6.99, df=1, p=0.008, Fishers exact test p=0.027).
Conclusions
These risk assessments may identify the extent of increased risk among a uniquely medically vulnerable patient group. Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population based cocooning and self-isolating guidance 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 | 2024-03-11T07:52:09Z |
| format | Article |
| id | doaj.art-ffb6a88b2cae455f807d157d1a449770 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:52:09Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-ffb6a88b2cae455f807d157d1a4497702023-11-17T05:06:33ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S375S37510.1192/j.eurpsy.2021.1004COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure servicesN. Basrak0N. Mulcrone1S. Sharifuddin2Z. Ghumman3N. Bechan4E. Mohamed5M. Murray6H. Rajendran7S. Gunnigle8M. Nolan9T. Quane10M. Terao11T. Hoare12K. Kirrane13H. Kennedy14M. Davoren15National Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, Ireland The Dundrum Centre For Forensic Excellence, Trinity College Dublin, Dublin, IrelandNational Forensic Mental Health Service, Central Mental Hospital Dundrum, Dundrum, Ireland The Dundrum Centre For Forensic Excellence, Trinity College Dublin, Dublin, Ireland Introduction Secure forensic mental health services treat patient with high rates of treatment resistant psychoses, typically schizophrenia. These groups have high rates of obesity and medical co-morbidities. Population based studies have identified high risk groups in the event of SARS-CoV-2 infection, including those with long term medical conditions. Objectives The aim of this study was to compare the vulnerability to serious adverse outcome in the event of COVID-19 infection in a forensic psychiatric patient population. Methods All patients of a complete 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 Eighty-two patients (58.2%) met criteria for obesity, 32 had type II diabetes and 28 were hypertensive. Mean chronological age was 45.5 years (SD 11.4, median 44.1), while mean COVID-AGE was 59.1 years (SD 19.4, median 58.0), mean difference 13.6 years (SD 15.6) paired t=10.9, df=140, p=0.000. Three patients (2.1%) were chronologically over 70 years compared to 40 (28.4%) with a COVID-AGE over 70 (X2=6.99, df=1, p=0.008, Fishers exact test p=0.027). Conclusions These risk assessments may identify the extent of increased risk among a uniquely medically vulnerable patient group. Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population based cocooning and self-isolating guidance 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/S092493382101004X/type/journal_articleCOVID-19forensic psychiatry |
| spellingShingle | N. Basrak N. Mulcrone S. Sharifuddin Z. Ghumman N. Bechan E. Mohamed M. Murray H. Rajendran S. Gunnigle M. Nolan T. Quane M. Terao T. Hoare K. Kirrane H. Kennedy M. Davoren COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services European Psychiatry COVID-19 forensic psychiatry |
| title | COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services |
| title_full | COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services |
| title_fullStr | COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services |
| title_full_unstemmed | COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services |
| title_short | COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services |
| title_sort | covid 19 in forensic psychiatry settings the unique vulnerability of patients in secure services |
| topic | COVID-19 forensic psychiatry |
| url | https://www.cambridge.org/core/product/identifier/S092493382101004X/type/journal_article |
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