Background People with severe mental ill health (SMI) experience a mortality gap of 15-20 years. COVID-19 has amplified population health inequalities, and there is concern that people with SMI will be disproportionately affected. Understanding how health risk behaviours have changed during the pandemic is important when developing strategies to mitigate future increases in health inequalities. Methods We sampled from an existing cohort of people with SMI. Researchers contacted participants by phone or post to invite them to take part in a survey about how the pandemic had affected them. We asked people about their health risk behaviours and how these had changed during the pandemic. We created an index of changed behaviours, comprising dietary factors, smoking, lack of exercise, and drinking patterns. By creating data linkages, we compared their responses during pandemic restrictions to responses they gave prior to the pandemic. Outcomes 367 people provided health risk data. 47.5% of participants reported taking less physical activity during the pandemic and of those who smoke 54.5% reported smoking more heavily. Self-reported deterioration in physical health and younger age were significantly associated with an increase in health risk behaviours (adjusted OR for physical health 1.59, 95%CI 1.22-2.07; adjusted OR for Age 0.99, 95%CI 0.98-1.00). Interpretation COVID-19 is likely to amplify health inequalities for people with SMI. Health services should target health risk behaviours for people with SMI to mitigate the immediate and long lasting impacts of the COVID-19 pandemic.

中文翻译：

---

COVID-19大流行期间严重精神疾病患者的健康风险行为：相关队列数据分析

背景患有严重精神疾病（SMI）的人的死亡率差距为15至20岁。COVID-19加剧了人口健康不平等，人们担心SMI患者将受到不成比例的影响。当制定缓解未来健康不平等加剧的策略时，了解大流行期间健康风险行为如何变化非常重要。方法我们从现有的SMI人群中抽样。研究人员通过电话或帖子与参与者联系，邀请他们参加有关大流行如何影响他们的调查。我们向人们询问了他们的健康风险行为以及在大流行期间这些行为是如何变化的。我们创建了一个行为改变指数，包括饮食因素，吸烟，缺乏运动和饮酒习惯。通过创建数据链接，我们将他们在大流行限制期间的反应与大流行之前的反应进行了比较。结果367人提供了健康风险数据。47.5％的参与者报告在大流行期间减少了体育锻炼，而吸烟者中有54.5％的参与者报告了吸烟程度更高。自我报告的身体健康状况恶化和年龄降低与健康风险行为的增加显着相关（身体健康OR调整为1.59，95％CI 1.22-2.07； 0.99年龄OR调整为95％CI 0.98-1.00）。解释COVID-19可能会加剧SMI患者的健康不平等。卫生服务应针对SMI患者的健康风险行为，以减轻COVID-19大流行的直接和长期影响。结果367人提供了健康风险数据。47.5％的参与者报告在大流行期间减少了体育锻炼，而吸烟者中有54.5％的参与者报告了吸烟程度更高。自我报告的身体健康状况恶化和年龄降低与健康风险行为的增加显着相关（身体健康OR调整为1.59，95％CI 1.22-2.07； 0.99年龄OR调整为95％CI 0.98-1.00）。解释COVID-19可能会加剧SMI患者的健康不平等。卫生服务应针对SMI患者的健康风险行为，以减轻COVID-19大流行的直接和长期影响。结果367人提供了健康风险数据。47.5％的参与者报告在大流行期间减少了体育锻炼，而吸烟者中有54.5％的参与者报告了吸烟程度更高。自我报告的身体健康状况恶化和年龄降低与健康风险行为的增加显着相关（身体健康OR调整为1.59，95％CI 1.22-2.07； 0.99年龄OR调整为95％CI 0.98-1.00）。解释COVID-19可能会加剧SMI患者的健康不平等。卫生服务应针对SMI患者的健康风险行为，以减轻COVID-19大流行的直接和长期影响。自我报告的身体健康状况恶化和年龄降低与健康风险行为的增加显着相关（身体健康OR调整为1.59，95％CI 1.22-2.07； 0.99年龄OR调整为95％CI 0.98-1.00）。解释COVID-19可能会加剧SMI患者的健康不平等。卫生服务应针对SMI患者的健康风险行为，以减轻COVID-19大流行的直接和长期影响。自我报告的身体健康状况恶化和年龄降低与健康风险行为的增加显着相关（身体健康OR调整为1.59，95％CI 1.22-2.07； 0.99年龄OR调整为95％CI 0.98-1.00）。解释COVID-19可能会加剧SMI患者的健康不平等。卫生服务应针对SMI患者的健康风险行为，以减轻COVID-19大流行的直接和长期影响。