ClinicalCodes.org
An online clinical codes repository to improve validity and reproducibility of medical database research
Research article:
Clinical management following self-harm in a UK-wide primary care cohort
Reference:
Matthew J Carr, Darren M Ashcroft, Evan Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb(2016) Clinical management following self-harm in a UK-wide primary care cohort. Journal of Affective Disorders, doi:
- Link to article
- Abstract
- Background: Little is known about the clinical management of patients in primary care following self-harm. Methods: A descriptive cohort study using data from 684 UK general practices that contributed to the Clinical Practice Research Datalink (CPRD) during 2001-2013. We identified 49,970 patients with a self-harm episode, 41,500 of whom had one complete year of follow-up. Results: Among those with complete follow-up, 26,065 (62.8%, 62.3-63.3) were prescribed psychotropic medication and 6,318 (15.2%, 14.9-15.6) were referred to mental health services; 4,105 (9.9%, CI 9.6-10.2) were medicated without an antecedent psychiatric diagnosis or referral, and 4,506 (10.9%, CI 10.6-11.2) had a diagnosis but were not subsequently medicated or referred. Patients registered at practices in the most deprived localities were 27.1% (CI 21.5-32.2) less likely to be referred than those in the least deprived. Despite a specifically flagged NICE ‘Do not do’ recommendation in 2011 against prescribing tricyclic antidepressants following self-harm because of their potentially lethal toxicity in overdose, 8.8% (CI 7.8-9.8) of individuals were issued a prescription in the subsequent year. The percentage prescribed Citalopram, an SSRI antidepressant with higher toxicity in overdose, fell sharply during 2012/2013 in the aftermath of a Medicines and Healthcare products Regulatory Agency (MHRA) safety alert issued in 2011. Conclusions: A relatively small percentage of these vulnerable patients are referred to mental health services, and reduced likelihood of referral in more deprived localities reflects a marked health inequality. National clinical guidelines have not yet been effective in reducing rates of tricyclic antidepressant prescribing for this high-risk group.
- Author for correspondence
- Matthew J Carr
- Email for correspondence
- matthew.carr@manchester.ac.uk
Code list: res36: Bipolar disorder
111 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 146D.00 | Read | H/O: manic depressive disorder | diagnostic | res36: Bipolar disorder | |||
| 1S42.00 | Read | Manic mood | diagnostic | res36: Bipolar disorder | |||
| 6657.00 | Read | On lithium | diagnostic | res36: Bipolar disorder | |||
| 6657.11 | Read | Lithium monitoring | diagnostic | res36: Bipolar disorder | |||
| 6657.12 | Read | Started lithium | diagnostic | res36: Bipolar disorder | |||
| E11..00 | Read | Affective psychoses | diagnostic | res36: Bipolar disorder | |||
| E110.00 | Read | Manic disorder, single episode | diagnostic | res36: Bipolar disorder | |||
| E110000 | Read | Single manic episode, unspecified | diagnostic | res36: Bipolar disorder | |||
| E110100 | Read | Single manic episode, mild | diagnostic | res36: Bipolar disorder | |||
| E110.11 | Read | Hypomanic psychoses | diagnostic | res36: Bipolar disorder | |||
| E110200 | Read | Single manic episode, moderate | diagnostic | res36: Bipolar disorder | |||
| E110300 | Read | Single manic episode, severe without mention of psychosis | diagnostic | res36: Bipolar disorder | |||
| E110400 | Read | Single manic episode, severe, with psychosis | diagnostic | res36: Bipolar disorder | |||
| E110600 | Read | Single manic episode in full remission | diagnostic | res36: Bipolar disorder | |||
| E110z00 | Read | Manic disorder, single episode NOS | diagnostic | res36: Bipolar disorder | |||
| E111.00 | Read | Recurrent manic episodes | diagnostic | res36: Bipolar disorder | |||
| E111000 | Read | Recurrent manic episodes, unspecified | diagnostic | res36: Bipolar disorder | |||
| E11..11 | Read | Bipolar psychoses | diagnostic | res36: Bipolar disorder | |||
| E111100 | Read | Recurrent manic episodes, mild | diagnostic | res36: Bipolar disorder | |||
| E111200 | Read | Recurrent manic episodes, moderate | diagnostic | res36: Bipolar disorder | |||
| E11..13 | Read | Manic psychoses | diagnostic | res36: Bipolar disorder | |||
| E111300 | Read | Recurrent manic episodes, severe without mention psychosis | diagnostic | res36: Bipolar disorder | |||
| E111400 | Read | Recurrent manic episodes, severe, with psychosis | diagnostic | res36: Bipolar disorder | |||
| E111500 | Read | Recurrent manic episodes, partial or unspecified remission | diagnostic | res36: Bipolar disorder | |||
| E111600 | Read | Recurrent manic episodes, in full remission | diagnostic | res36: Bipolar disorder | |||
| E111z00 | Read | Recurrent manic episode NOS | diagnostic | res36: Bipolar disorder | |||
| E114.00 | Read | Bipolar affective disorder, currently manic | diagnostic | res36: Bipolar disorder | |||
| E114000 | Read | Bipolar affective disorder, currently manic, unspecified | diagnostic | res36: Bipolar disorder | |||
| E114100 | Read | Bipolar affective disorder, currently manic, mild | diagnostic | res36: Bipolar disorder | |||
| E114.11 | Read | Manic-depressive - now manic | diagnostic | res36: Bipolar disorder | |||
| E114200 | Read | Bipolar affective disorder, currently manic, moderate | diagnostic | res36: Bipolar disorder | |||
| E114300 | Read | Bipolar affect disord, currently manic, severe, no psychosis | diagnostic | res36: Bipolar disorder | |||
| E114400 | Read | Bipolar affect disord, currently manic,severe with psychosis | diagnostic | res36: Bipolar disorder | |||
| E114500 | Read | Bipolar affect disord,currently manic, part/unspec remission | diagnostic | res36: Bipolar disorder | |||
| E114600 | Read | Bipolar affective disorder, currently manic, full remission | diagnostic | res36: Bipolar disorder | |||
| E114z00 | Read | Bipolar affective disorder, currently manic, NOS | diagnostic | res36: Bipolar disorder | |||
| E115.00 | Read | Bipolar affective disorder, currently depressed | diagnostic | res36: Bipolar disorder | |||
| E115000 | Read | Bipolar affective disorder, currently depressed, unspecified | diagnostic | res36: Bipolar disorder | |||
| E115100 | Read | Bipolar affective disorder, currently depressed, mild | diagnostic | res36: Bipolar disorder | |||
| E115.11 | Read | Manic-depressive - now depressed | diagnostic | res36: Bipolar disorder | |||
| E115200 | Read | Bipolar affective disorder, currently depressed, moderate | diagnostic | res36: Bipolar disorder | |||
| E115300 | Read | Bipolar affect disord, now depressed, severe, no psychosis | diagnostic | res36: Bipolar disorder | |||
| E115400 | Read | Bipolar affect disord, now depressed, severe with psychosis | diagnostic | res36: Bipolar disorder | |||
| E115500 | Read | Bipolar affect disord, now depressed, part/unspec remission | diagnostic | res36: Bipolar disorder | |||
| E115600 | Read | Bipolar affective disorder, now depressed, in full remission | diagnostic | res36: Bipolar disorder | |||
| E115z00 | Read | Bipolar affective disorder, currently depressed, NOS | diagnostic | res36: Bipolar disorder | |||
| E116.00 | Read | Mixed bipolar affective disorder | diagnostic | res36: Bipolar disorder | |||
| E116000 | Read | Mixed bipolar affective disorder, unspecified | diagnostic | res36: Bipolar disorder | |||
| E116100 | Read | Mixed bipolar affective disorder, mild | diagnostic | res36: Bipolar disorder | |||
| E116200 | Read | Mixed bipolar affective disorder, moderate | diagnostic | res36: Bipolar disorder | |||
| E116300 | Read | Mixed bipolar affective disorder, severe, without psychosis | diagnostic | res36: Bipolar disorder | |||
| E116400 | Read | Mixed bipolar affective disorder, severe, with psychosis | diagnostic | res36: Bipolar disorder | |||
| E116500 | Read | Mixed bipolar affective disorder, partial/unspec remission | diagnostic | res36: Bipolar disorder | |||
| E116600 | Read | Mixed bipolar affective disorder, in full remission | diagnostic | res36: Bipolar disorder | |||
| E116z00 | Read | Mixed bipolar affective disorder, NOS | diagnostic | res36: Bipolar disorder | |||
| E117.00 | Read | Unspecified bipolar affective disorder | diagnostic | res36: Bipolar disorder | |||
| E117000 | Read | Unspecified bipolar affective disorder, unspecified | diagnostic | res36: Bipolar disorder | |||
| E117100 | Read | Unspecified bipolar affective disorder, mild | diagnostic | res36: Bipolar disorder | |||
| E117200 | Read | Unspecified bipolar affective disorder, moderate | diagnostic | res36: Bipolar disorder | |||
| E117300 | Read | Unspecified bipolar affective disorder, severe, no psychosis | diagnostic | res36: Bipolar disorder | |||
| E117400 | Read | Unspecified bipolar affective disorder,severe with psychosis | diagnostic | res36: Bipolar disorder | |||
| E117500 | Read | Unspecified bipolar affect disord, partial/unspec remission | diagnostic | res36: Bipolar disorder | |||
| E117600 | Read | Unspecified bipolar affective disorder, in full remission | diagnostic | res36: Bipolar disorder | |||
| E117z00 | Read | Unspecified bipolar affective disorder, NOS | diagnostic | res36: Bipolar disorder | |||
| E11y.00 | Read | Other and unspecified manic-depressive psychoses | diagnostic | res36: Bipolar disorder | |||
| E11y000 | Read | Unspecified manic-depressive psychoses | diagnostic | res36: Bipolar disorder | |||
| E11y100 | Read | Atypical manic disorder | diagnostic | res36: Bipolar disorder | |||
| E11y300 | Read | Other mixed manic-depressive psychoses | diagnostic | res36: Bipolar disorder | |||
| E11yz00 | Read | Other and unspecified manic-depressive psychoses NOS | diagnostic | res36: Bipolar disorder | |||
| Eu3..00 | Read | [X]Mood - affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu30.00 | Read | [X]Manic episode | diagnostic | res36: Bipolar disorder | |||
| Eu30000 | Read | [X]Hypomania | diagnostic | res36: Bipolar disorder | |||
| Eu30100 | Read | [X]Mania without psychotic symptoms | diagnostic | res36: Bipolar disorder | |||
| Eu30.11 | Read | [X]Bipolar disorder, single manic episode | diagnostic | res36: Bipolar disorder | |||
| Eu30200 | Read | [X]Mania with psychotic symptoms | diagnostic | res36: Bipolar disorder | |||
| Eu30211 | Read | [X]Mania with mood-congruent psychotic symptoms | diagnostic | res36: Bipolar disorder | |||
| Eu30212 | Read | [X]Mania with mood-incongruent psychotic symptoms | diagnostic | res36: Bipolar disorder | |||
| Eu30y00 | Read | [X]Other manic episodes | diagnostic | res36: Bipolar disorder | |||
| Eu30z00 | Read | [X]Manic episode, unspecified | diagnostic | res36: Bipolar disorder | |||
| Eu30z11 | Read | [X]Mania NOS | diagnostic | res36: Bipolar disorder | |||
| Eu31.00 | Read | [X]Bipolar affective disorder | diagnostic | res36: Bipolar disorder | |||
| Eu31000 | Read | [X]Bipolar affective disorder, current episode hypomanic | diagnostic | res36: Bipolar disorder | |||
| Eu31100 | Read | [X]Bipolar affect disorder cur epi manic wout psychotic symp | diagnostic | res36: Bipolar disorder | |||
| Eu31.11 | Read | [X]Manic-depressive illness | diagnostic | res36: Bipolar disorder | |||
| Eu31.12 | Read | [X]Manic-depressive psychosis | diagnostic | res36: Bipolar disorder | |||
| Eu31.13 | Read | [X]Manic-depressive reaction | diagnostic | res36: Bipolar disorder | |||
| Eu31200 | Read | [X]Bipolar affect disorder cur epi manic with psychotic symp | diagnostic | res36: Bipolar disorder | |||
| Eu31300 | Read | [X]Bipolar affect disorder cur epi mild or moderate depressn | diagnostic | res36: Bipolar disorder | |||
| Eu31400 | Read | [X]Bipol aff disord, curr epis sev depress, no psychot symp | diagnostic | res36: Bipolar disorder | |||
| Eu31500 | Read | [X]Bipolar affect dis cur epi severe depres with psyc symp | diagnostic | res36: Bipolar disorder | |||
| Eu31600 | Read | [X]Bipolar affective disorder, current episode mixed | diagnostic | res36: Bipolar disorder | |||
| Eu31700 | Read | [X]Bipolar affective disorder, currently in remission | diagnostic | res36: Bipolar disorder | |||
| Eu31y00 | Read | [X]Other bipolar affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu31y11 | Read | [X]Bipolar II disorder | diagnostic | res36: Bipolar disorder | |||
| Eu31y12 | Read | [X]Recurrent manic episodes | diagnostic | res36: Bipolar disorder | |||
| Eu31z00 | Read | [X]Bipolar affective disorder, unspecified | diagnostic | res36: Bipolar disorder | |||
| Eu33213 | Read | [X]Manic-depress psychosis,depressd,no psychotic symptoms | diagnostic | res36: Bipolar disorder | |||
| Eu33312 | Read | [X]Manic-depress psychosis,depressed type+psychotic symptoms | diagnostic | res36: Bipolar disorder | |||
| Eu34.00 | Read | [X]Persistent mood affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu34000 | Read | [X]Cyclothymia | diagnostic | res36: Bipolar disorder | |||
| Eu34y00 | Read | [X]Other persistent mood affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu34z00 | Read | [X]Persistent mood affective disorder, unspecified | diagnostic | res36: Bipolar disorder | |||
| Eu3y.00 | Read | [X]Other mood affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu3y000 | Read | [X]Other single mood affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu3y011 | Read | [X]Mixed affective episode | diagnostic | res36: Bipolar disorder | |||
| Eu3y100 | Read | [X]Other recurrent mood affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu3yy00 | Read | [X]Other specified mood affective disorders | diagnostic | res36: Bipolar disorder | |||
| Eu3z.00 | Read | [X]Unspecified mood affective disorder | diagnostic | res36: Bipolar disorder | |||
| Eu3z.11 | Read | [X]Affective psychosis NOS | diagnostic | res36: Bipolar disorder | |||
| ZV11111 | Read | [V]Personal history of manic-depressive psychosis | diagnostic | res36: Bipolar disorder | |||
| ZV11112 | Read | [V]Personal history of manic-depressive psychosis | diagnostic | res36: Bipolar disorder |
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