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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: Z-drugs
48 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 14365 | Read | Zopiclone 3.75mg/5ml oral suspension | drug | res201: Z-drugs | |||
| 15852 | Read | Zileze 7.5 tablets (Opus Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 2017 | Read | Zolpidem 5mg tablets | drug | res201: Z-drugs | |||
| 24135 | Read | Zopiclone 7.5mg tablets (Actavis UK Ltd) | drug | res201: Z-drugs | |||
| 29219 | Read | Zopiclone 3.75mg tablets (Actavis UK Ltd) | drug | res201: Z-drugs | |||
| 29869 | Read | Zolpidem 5mg Tablet (Winthrop Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 30056 | Read | Zopiclone 3.75mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res201: Z-drugs | |||
| 30377 | Read | Zopiclone 3.75mg tablets (Mylan Ltd) | drug | res201: Z-drugs | |||
| 30981 | Read | Zolpidem 10mg tablets (A A H Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 3126 | Read | Stilnoct 5mg tablets (Sanofi) | drug | res201: Z-drugs | |||
| 31710 | Read | Zolpidem 5mg tablets (A A H Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 33045 | Read | Zopiclone 7.5mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res201: Z-drugs | |||
| 3320 | Read | Zimovane 7.5mg tablets (Sanofi) | drug | res201: Z-drugs | |||
| 33663 | Read | Zopiclone 7.5mg tablets (Mylan Ltd) | drug | res201: Z-drugs | |||
| 33841 | Read | Zolpidem 10mg tablets (Mylan Ltd) | drug | res201: Z-drugs | |||
| 34372 | Read | Zopiclone 7.5mg tablets (PLIVA Pharma Ltd) | drug | res201: Z-drugs | |||
| 34612 | Read | Zopiclone 3.75mg tablets (A A H Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 34777 | Read | Zopiclone 3.75mg tablets (Teva UK Ltd) | drug | res201: Z-drugs | |||
| 34823 | Read | Zopiclone 7.5mg tablets (Teva UK Ltd) | drug | res201: Z-drugs | |||
| 34874 | Read | Zopiclone 7.5mg tablets (Kent Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 34897 | Read | Zopiclone 3.75mg tablets (Kent Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 3741 | Read | Stilnoct 10mg tablets (Sanofi) | drug | res201: Z-drugs | |||
| 41539 | Read | Zolpidem 10mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res201: Z-drugs | |||
| 41696 | Read | Zolpidem 5mg tablets (Teva UK Ltd) | drug | res201: Z-drugs | |||
| 41697 | Read | Zolpidem 5mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res201: Z-drugs | |||
| 4187 | Read | Zimovane LS 3.75mg tablets (Sanofi) | drug | res201: Z-drugs | |||
| 42089 | Read | Zolpidem 10mg Tablet (Winthrop Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 43445 | Read | Zopiclone 7.5mg tablets (A A H Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 43560 | Read | Zolpidem 10mg tablets (Teva UK Ltd) | drug | res201: Z-drugs | |||
| 45353 | Read | Zopiclone 7.5mg tablets (Sandoz Ltd) | drug | res201: Z-drugs | |||
| 46799 | Read | Zopiclone 3.75mg/5ml oral solution | drug | res201: Z-drugs | |||
| 5058 | Read | Zileze 3.75 tablets (Opus Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 52022 | Read | Zimovane 7.5mg tablets (Lexon (UK) Ltd) | drug | res201: Z-drugs | |||
| 5306 | Read | Sonata 10mg capsules (Meda Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 5352 | Read | Zaleplon 10mg capsules | drug | res201: Z-drugs | |||
| 5459 | Read | Zolpidem 10mg tablets | drug | res201: Z-drugs | |||
| 57937 | Read | Zopiclone 3.75mg tablets (Almus Pharmaceuticals Ltd) | drug | res201: Z-drugs | |||
| 5916 | Read | Zaleplon 5mg capsules | drug | res201: Z-drugs | |||
| 59640 | Read | Zopiclone 7.5mg/5ml oral suspension | drug | res201: Z-drugs | |||
| 61477 | Read | Zopiclone 7.5mg/5ml oral solution | drug | res201: Z-drugs | |||
| 63592 | Read | Zopiclone 7.5mg tablets (Sigma Pharmaceuticals Plc) | drug | res201: Z-drugs | |||
| 65190 | Read | Zolpidem 10mg tablets (Zentiva) | drug | res201: Z-drugs | |||
| 65637 | Read | Zopiclone 7.5mg tablets (Phoenix Healthcare Distribution Ltd) | drug | res201: Z-drugs | |||
| 66 | Read | Zopiclone 7.5mg tablets | drug | res201: Z-drugs | |||
| 70727 | Read | Zopiclone 3.75mg tablets (Sigma Pharmaceuticals Plc) | drug | res201: Z-drugs | |||
| 71089 | Read | Zopiclone 3.75mg tablets (Bristol Laboratories Ltd) | drug | res201: Z-drugs | |||
| 721 | Read | Zopiclone 3.75mg tablets | drug | res201: Z-drugs | |||
| 9598 | Read | Sonata 5mg capsules (Meda Pharmaceuticals Ltd) | drug | res201: Z-drugs |
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