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Research article:

The epidemiology of self-harm in a UK-wide primary care patient cohort, 2001-2013

Reference:

Matthew J. Carr, Darren M. Ashcroft, Evangelos Kontopantelis, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T. Webb (2015) The epidemiology of self-harm in a UK-wide primary care patient cohort, 2001-2013. BMC Psychiatry, doi:

Link to article
Abstract
Background: Most of the research conducted on people who harm themselves has been undertaken in secondary healthcare settings. Little is known about the frequency of self-harm in primary care patient populations. This is the first study to describe the epidemiology of self-harm presentations to primary care using broadly representative national data from across the United Kingdom (UK). Methods: Using the Clinical Practice Research Datalink (CPRD), we calculated directly standardised rates of incidence and annual presentation during 2001-2013. Rates were compared by gender and age and across the nations of the UK, and also by degree of socioeconomic deprivation measured ecologically at general practice level. Results: We found significantly elevated rates in females vs. males for incidence (rate ratio - RR, 1.45, 95% confidence interval - CI, 1.42-1.47) and for annual presentation (RR 1.56, CI 1.54-1.58). An increasing trend over time in incidence was apparent for males (P<0.001) but not females (P=0.08), and both genders exhibited rising temporal trends in presentation rates (P<0.001). We observed a decreasing gradient of risk with increasing age and markedly elevated risk for females in the youngest age group (aged 15-24 years vs. all other females: RR 3.75, CI 3.67-3.83). Increasing presentation rates over time were observed for males across all age bands (P<0.001). We found higher rates when comparing Northern Ireland, Scotland, and Wales with England, and increasing rates of presentation over time for all four nations. We also observed higher rates with increasing levels of deprivation - most vs. least deprived male patients: RR 2.17, CI 2.10-2.25. Conclusions: Incorporating data from primary care yields a more accurate quantification of the health burden of self-harm. These novel findings may be useful in informing public health programmes and the targeting of high-risk groups toward the ultimate goal of lowering risk of self-harm repetition and premature death in this population.
Author for correspondence
Matthew J. Carr
Email for correspondence
matthew.carr@manchester.ac.uk

Code list: res33: Self-harm

261 codes in list

Code Coding system Description Entity type List name
14K1.00 Read Intentional overdose of prescription only medication diagnostic res33: Self-harm
SL...14 Read Overdose of biological substance diagnostic res33: Self-harm
SL...15 Read Overdose of drug diagnostic res33: Self-harm
SL90.00 Read Antidepressant poisoning diagnostic res33: Self-harm
SL90z00 Read Anti-depressant poisoning NOS diagnostic res33: Self-harm
SLHz.00 Read Drug and medicament poisoning NOS diagnostic res33: Self-harm
TK...00 Read Suicide and selfinflicted injury diagnostic res33: Self-harm
TK0..00 Read Suicide + selfinflicted poisoning by solid/liquid substances diagnostic res33: Self-harm
TK00.00 Read Suicide + selfinflicted poisoning by analgesic/antipyretic diagnostic res33: Self-harm
TK01.00 Read Suicide + selfinflicted poisoning by barbiturates diagnostic res33: Self-harm
TK01000 Read Suicide and self inflicted injury by Amylobarbitone diagnostic res33: Self-harm
TK01100 Read Suicide and self inflicted injury by Barbitone diagnostic res33: Self-harm
TK01400 Read Suicide and self inflicted injury by Phenobarbitone diagnostic res33: Self-harm
TK02.00 Read Suicide + selfinflicted poisoning by oth sedatives/hypnotics diagnostic res33: Self-harm
TK03.00 Read Suicide + selfinflicted poisoning tranquilliser/psychotropic diagnostic res33: Self-harm
TK04.00 Read Suicide + selfinflicted poisoning by other drugs/medicines diagnostic res33: Self-harm
TK05.00 Read Suicide + selfinflicted poisoning by drug or medicine NOS diagnostic res33: Self-harm
TK06.00 Read Suicide + selfinflicted poisoning by agricultural chemical diagnostic res33: Self-harm
TK07.00 Read Suicide + selfinflicted poisoning by corrosive/caustic subst diagnostic res33: Self-harm
TK0z.00 Read Suicide + selfinflicted poisoning by solid/liquid subst NOS diagnostic res33: Self-harm
TK1..00 Read Suicide + selfinflicted poisoning by gases in domestic use diagnostic res33: Self-harm
TK10.00 Read Suicide + selfinflicted poisoning by gas via pipeline diagnostic res33: Self-harm
TK...11 Read Cause of overdose - deliberate diagnostic res33: Self-harm
TK11.00 Read Suicide + selfinflicted poisoning by liquified petrol gas diagnostic res33: Self-harm
TK...12 Read Injury - self-inflicted diagnostic res33: Self-harm
TK...13 Read Poisoning - self-inflicted diagnostic res33: Self-harm
TK...14 Read Suicide and self harm diagnostic res33: Self-harm
TK...15 Read Attempted suicide diagnostic res33: Self-harm
TK...17 Read Para-suicide diagnostic res33: Self-harm
TK1y.00 Read Suicide and selfinflicted poisoning by other utility gas diagnostic res33: Self-harm
TK1z.00 Read Suicide + selfinflicted poisoning by domestic gases NOS diagnostic res33: Self-harm
TK2..00 Read Suicide + selfinflicted poisoning by other gases and vapours diagnostic res33: Self-harm
TK20.00 Read Suicide + selfinflicted poisoning by motor veh exhaust gas diagnostic res33: Self-harm
TK21.00 Read Suicide and selfinflicted poisoning by other carbon monoxide diagnostic res33: Self-harm
TK2z.00 Read Suicide + selfinflicted poisoning by gases and vapours NOS diagnostic res33: Self-harm
TK3..00 Read Suicide + selfinflicted injury by hang/strangulate/suffocate diagnostic res33: Self-harm
TK30.00 Read Suicide and selfinflicted injury by hanging diagnostic res33: Self-harm
TK31.00 Read Suicide + selfinflicted injury by suffocation by plastic bag diagnostic res33: Self-harm
TK3y.00 Read Suicide + selfinflicted inj oth mean hang/strangle/suffocate diagnostic res33: Self-harm
TK3z.00 Read Suicide + selfinflicted inj by hang/strangle/suffocate NOS diagnos