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Research article:
Identifying prior signals of bipolar disorder using primary care electronic health records
Reference:
Catharine Morgan, Darren M Ashcroft, Carolyn A Chew-Graham, Matthew Sperrin, Roger T Webb, Anya Francis, Jan Scott, Alison R Yung(2023) Identifying prior signals of bipolar disorder using primary care electronic health records. British Journal of General Practice, doi:
- Link to article
- Abstract
- Background: Bipolar disorders (BD) are serious mental illnesses yet evidence suggests that the diagnosis and treatment of BD can be delayed by around 6 years. Aim: To identify signals of undiagnosed BD using routinely collected electronic health records. Methods: A nested case-control study conducted using the Clinical Practice Research Datalink (CPRD) GOLD dataset, an anonymised electronic primary care patient database linked with hospital records. Cases were adult patients with incident BD diagnoses between 1st Jan. 2010 and 31st July 2017. These patients were matched by age, sex, and registered general practice to 20 controls without a recorded BD. Annual episode incidence rates were estimated and odds ratios from conditional logistic regression models were reported for recorded health events prior to index (diagnosis) date. Results: There were 2,366 patients with incident BD diagnoses and 47,138 matched control patients (median age 40 years; 60.5% females). Compared with controls, BD cases had higher incidence of diagnosed depressive, psychotic, anxiety and personality disorders recorded and escalating self-harm, up to 10 years before BD diagnosis. Sleep disturbance, substance misuse and mood swings were more frequent among cases than controls. Also, cases had more frequent face-to-face consultations and were more likely to miss multiple scheduled appointments and prescribed three different psychotropic medication classes in a given year. Conclusion: Psychiatric diagnoses, psychotropic prescriptions and health service use patterns might be signals of unreported BD. Recognition of these signals could prompt further investigation for undiagnosed significant psychopathology, leading to timely referral, assessment and initiation of appropriate treatments.
- Author for correspondence
- catharine Morgan
- Email for correspondence
- cathy.morgan@manchester.ac.uk
Code list: res201: Gabapentoids
147 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 10007 | Read | Neurontin 100mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 10189 | Read | Lyrica 300mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 1584 | Read | Gabapentin 300mg capsules | drug | res201: Gabapentoids | |||
| 16215 | Read | Neurontin 400mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 16404 | Read | Neurontin titration pack (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 16509 | Read | Lyrica 150mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 16542 | Read | Lyrica 25mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 17564 | Read | Neurontin 600mg tablets (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 18211 | Read | Gabapentin 250mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 25815 | Read | Gabapentin 400mg/5ml oral suspension | drug | res201: Gabapentoids | |||
| 27454 | Read | Gabapentin 300mg capsules (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 28713 | Read | Neurontin 800mg tablets (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 34506 | Read | Gabapentin 100mg capsules (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 34606 | Read | Gabapentin 100mg capsules (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 34716 | Read | Gabapentin 300mg capsules (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 34946 | Read | Gabapentin 600mg tablets (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 37801 | Read | Pregabalin 225mg capsules | drug | res201: Gabapentoids | |||
| 38293 | Read | Lyrica 225mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 44022 | Read | Gabapentin 250mg/5ml oral suspension | drug | res201: Gabapentoids | |||
| 44187 | Read | Gabapentin 600mg tablets (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 44261 | Read | Gabapentin 250mg/5ml Oral solution (Boots Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 47579 | Read | Gabapentin 100mg capsules (Sandoz Ltd) | drug | res201: Gabapentoids | |||
| 4781 | Read | Gabapentin 400mg capsules | drug | res201: Gabapentoids | |||
| 48035 | Read | Gabapentin 300mg capsules (Mylan) | drug | res201: Gabapentoids | |||
| 48060 | Read | Gabapentin 300mg capsules (Sandoz Ltd) | drug | res201: Gabapentoids | |||
| 48253 | Read | Lyrica 150mg capsules (Lexon (UK) Ltd) | drug | res201: Gabapentoids | |||
| 51118 | Read | Gabapentin 300mg capsules (Ranbaxy (UK) Ltd) | drug | res201: Gabapentoids | |||
| 51227 | Read | Pregabalin 20mg/ml oral solution sugar free | drug | res201: Gabapentoids | |||
| 51924 | Read | Lyrica 20mg/ml oral solution (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 5221 | Read | Gabapentin 600mg tablets | drug | res201: Gabapentoids | |||
| 52547 | Read | Lyrica 50mg capsules (Waymade Healthcare Plc) | drug | res201: Gabapentoids | |||
| 53296 | Read | Gabapentin 300mg capsules (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 53784 | Read | Gabapentin 300mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 54609 | Read | Gabapentin 50mg/ml oral solution sugar free | drug | res201: Gabapentoids | |||
| 55008 | Read | Gabapentin 6% gel | drug | res201: Gabapentoids | |||
| 55535 | Read | Gabapentin 300mg capsules (Almus Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 55624 | Read | Gabapentin 300mg capsules (Bristol Laboratories Ltd) | drug | res201: Gabapentoids | |||
| 55972 | Read | Pregabalin 150mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 57120 | Read | Gabapentin 100mg capsules (Mylan) | drug | res201: Gabapentoids | |||
| 57527 | Read | Neurontin 300mg capsules (Dowelhurst Ltd) | drug | res201: Gabapentoids | |||
| 57649 | Read | Gabapentin 300mg capsules (Arrow Generics Ltd) | drug | res201: Gabapentoids | |||
| 58162 | Read | Gabapentin 600mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 58382 | Read | Gabapentin 100mg capsules (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 58383 | Read | Gabapentin 400mg capsules (Almus Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 58472 | Read | Gabapentin 300mg/5ml oral suspension | drug | res201: Gabapentoids | |||
| 58960 | Read | Gabapentin 100mg capsules (Zentiva) | drug | res201: Gabapentoids | |||
| 59147 | Read | Gabapentin 600mg tablets (Zentiva) | drug | res201: Gabapentoids | |||
| 59196 | Read | Gabapentin 400mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 60389 | Read | Gabapentin 300mg capsules (Creo Pharma Ltd) | drug | res201: Gabapentoids | |||
| 60543 | Read | Pregabalin 75mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 61266 | Read | Gabapentin 300mg capsules (Waymade Healthcare Plc) | drug | res201: Gabapentoids | |||
| 6304 | Read | Neurontin 300mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 63069 | Read | Rewisca 75mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63088 | Read | Rewisca 50mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63089 | Read | Rewisca 300mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63090 | Read | Rewisca 150mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63091 | Read | Rewisca 100mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63174 | Read | Rewisca 200mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63300 | Read | Rewisca 25mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63317 | Read | Rewisca 225mg capsules (Consilient Health Ltd) | drug | res201: Gabapentoids | |||
| 63375 | Read | Gabapentin 200mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 63432 | Read | Gabapentin 300mg capsules (Zentiva) | drug | res201: Gabapentoids | |||
| 63877 | Read | Pregabalin 50mg capsules (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 63964 | Read | Alzain 25mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 63965 | Read | Alzain 100mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64005 | Read | Pregabalin 100mg capsules (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 64037 | Read | Alzain 300mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64038 | Read | Alzain 225mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64039 | Read | Alzain 150mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64040 | Read | Alzain 75mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64041 | Read | Alzain 50mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64042 | Read | Alzain 200mg capsules (Dr Reddy's Laboratories (UK) Ltd) | drug | res201: Gabapentoids | |||
| 64213 | Read | Gabapentin 600mg tablets (DE Pharmaceuticals) | drug | res201: Gabapentoids | |||
| 64285 | Read | Pregabalin 150mg/5ml oral suspension | drug | res201: Gabapentoids | |||
| 64302 | Read | Gabapentin 300mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 64306 | Read | Gabapentin 50mg/ml oral solution sugar free (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 64497 | Read | Lyrica 75mg capsules (Waymade Healthcare Plc) | drug | res201: Gabapentoids | |||
| 64568 | Read | Lyrica 150mg capsules (Sigma Pharmaceuticals Plc) | drug | res201: Gabapentoids | |||
| 64981 | Read | Gabapentin 100mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 65069 | Read | Pregabalin 75mg capsules (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 65073 | Read | Pregabalin 25mg capsules (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 65218 | Read | Lecaent 50mg capsules (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 65606 | Read | Pregabalin 50mg capsules (Accord Healthcare Ltd) | drug | res201: Gabapentoids | |||
| 65787 | Read | Pregabalin 50mg capsules (Sandoz Ltd) | drug | res201: Gabapentoids | |||
| 6584 | Read | Lyrica 75mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 65863 | Read | Lyrica 75mg capsules (Stephar (U.K.) Ltd) | drug | res201: Gabapentoids | |||
| 660 | Read | Gabapentin 100mg capsules | drug | res201: Gabapentoids | |||
| 6631 | Read | Pregabalin 150mg capsules | drug | res201: Gabapentoids | |||
| 66509 | Read | Pregabalin 75mg capsules (Zentiva) | drug | res201: Gabapentoids | |||
| 66617 | Read | Gabapentin 300mg capsules (Medreich Plc) | drug | res201: Gabapentoids | |||
| 66941 | Read | Lecaent 75mg capsules (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 67053 | Read | Pregabalin 75mg capsules (DE Pharmaceuticals) | drug | res201: Gabapentoids | |||
| 67091 | Read | Gabapentin 50mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 67184 | Read | Lyrica 50mg capsules (Mawdsley-Brooks & Company Ltd) | drug | res201: Gabapentoids | |||
| 67384 | Read | Pregabalin 75mg/5ml oral suspension | drug | res201: Gabapentoids | |||
| 67440 | Read | Pregabalin 300mg capsules (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 67969 | Read | Gabapentin 300mg capsules (DE Pharmaceuticals) | drug | res201: Gabapentoids | |||
| 68014 | Read | Lyrica 75mg capsules (Lexon (UK) Ltd) | drug | res201: Gabapentoids | |||
| 68047 | Read | Gabapentin 300mg capsules (Phoenix Healthcare Distribution Ltd) | drug | res201: Gabapentoids | |||
| 68049 | Read | Gabapentin 100mg capsules (Almus Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 68441 | Read | Pregabalin 25mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 69034 | Read | Pregabalin 300mg capsules (Mylan) | drug | res201: Gabapentoids | |||
| 69125 | Read | Axalid 100mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69296 | Read | Axalid 25mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 6936 | Read | Pregabalin 50mg capsules | drug | res201: Gabapentoids | |||
| 69418 | Read | Axalid 300mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 6949 | Read | Pregabalin 200mg capsules | drug | res201: Gabapentoids | |||
| 69497 | Read | Axalid 225mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69498 | Read | Axalid 75mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69499 | Read | Axalid 150mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69501 | Read | Lyrica 75mg capsules (DE Pharmaceuticals) | drug | res201: Gabapentoids | |||
| 69554 | Read | Axalid 50mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69781 | Read | Lyrica 25mg capsules (Lexon (UK) Ltd) | drug | res201: Gabapentoids | |||
| 69799 | Read | Axalid 200mg capsules (Kent Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69877 | Read | Lecaent 300mg capsules (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 69914 | Read | Gabapentin 300mg capsules (Almus Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 69987 | Read | Pregabalin 75mg capsules (A A H Pharmaceuticals Ltd) | drug | res201: Gabapentoids | |||
| 6999 | Read | Pregabalin 100mg capsules | drug | res201: Gabapentoids | |||
| 7005 | Read | Pregabalin 300mg capsules | drug | res201: Gabapentoids | |||
| 70064 | Read | Pregabalin 25mg capsules (Accord Healthcare Ltd) | drug | res201: Gabapentoids | |||
| 70229 | Read | Pregabalin 75mg capsules (Mylan) | drug | res201: Gabapentoids | |||
| 70247 | Read | Gabapentin 600mg tablets (Aurobindo Pharma Ltd) | drug | res201: Gabapentoids | |||
| 70459 | Read | Gabapentin 400mg capsules (Waymade Healthcare Plc) | drug | res201: Gabapentoids | |||
| 70478 | Read | Pregabalin 150mg capsules (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 70506 | Read | Gabapentin 500mg/5ml oral solution | drug | res201: Gabapentoids | |||
| 70544 | Read | Pregabalin 150mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70545 | Read | Pregabalin 25mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70546 | Read | Pregabalin 50mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70648 | Read | Pregabalin 300mg capsules (Teva UK Ltd) | drug | res201: Gabapentoids | |||
| 70729 | Read | Pregabalin 200mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70730 | Read | Pregabalin 100mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70731 | Read | Pregabalin 75mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70735 | Read | Pregabalin 300mg capsules (Alliance Healthcare (Distribution) Ltd) | drug | res201: Gabapentoids | |||
| 70738 | Read | Gabapentin 600mg tablets (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 70954 | Read | Gabapentin 300mg capsules (Brown & Burk UK Ltd) | drug | res201: Gabapentoids | |||
| 71013 | Read | Gabapentin 100mg capsules (Bristol Laboratories Ltd) | drug | res201: Gabapentoids | |||
| 71221 | Read | Lecaent 200mg capsules (Actavis UK Ltd) | drug | res201: Gabapentoids | |||
| 71313 | Read | Pregabalin 50mg capsules (Zentiva) | drug | res201: Gabapentoids | |||
| 71461 | Read | Pregabalin 50mg/5ml oral suspension | drug | res201: Gabapentoids | |||
| 71533 | Read | Pregabalin 50mg capsules (Mylan) | drug | res201: Gabapentoids | |||
| 7208 | Read | Lyrica 100mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 7209 | Read | Lyrica 50mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 7394 | Read | Lyrica 200mg capsules (Pfizer Ltd) | drug | res201: Gabapentoids | |||
| 7538 | Read | Gabapentin 800mg tablets | drug | res201: Gabapentoids | |||
| 790 | Read | Pregabalin 25mg capsules | drug | res201: Gabapentoids | |||
| 819 | Read | Pregabalin 75mg capsules | drug | res201: Gabapentoids | |||
| 9979 | Read | Gabapentin 600mg tablets and Gabapentin 300mg capsules | drug | res201: Gabapentoids |
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