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: Eating disorder
38 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 1612.00 | Read | Appetite loss - anorexia | diagnostic | res36: Eating disorder | |||
| 1612.11 | Read | Anorexia symptom | diagnostic | res36: Eating disorder | |||
| 1614.00 | Read | Excessive eating - polyphagia | diagnostic | res36: Eating disorder | |||
| 1614.11 | Read | Hyperalimentation - symptom | diagnostic | res36: Eating disorder | |||
| 1614.12 | Read | Polyphagia symptom | diagnostic | res36: Eating disorder | |||
| 8HTN.00 | Read | Referral to eating disorders clinic | diagnostic | res36: Eating disorder | |||
| 9Nk9.00 | Read | Seen in eating disorder clinic | diagnostic | res36: Eating disorder | |||
| E271.00 | Read | Anorexia nervosa | diagnostic | res36: Eating disorder | |||
| E275.00 | Read | Other and unspecified non-organic eating disorders | diagnostic | res36: Eating disorder | |||
| E275000 | Read | Unspecified non-organic eating disorder | diagnostic | res36: Eating disorder | |||
| E275100 | Read | Bulimia (non-organic overeating) | diagnostic | res36: Eating disorder | |||
| E275111 | Read | Compulsive eating disorder | diagnostic | res36: Eating disorder | |||
| E275y00 | Read | Other specified non-organic eating disorder | diagnostic | res36: Eating disorder | |||
| E275z00 | Read | Non-organic eating disorder NOS | diagnostic | res36: Eating disorder | |||
| Eu50.00 | Read | [X]Eating disorders | diagnostic | res36: Eating disorder | |||
| Eu50000 | Read | [X]Anorexia nervosa | diagnostic | res36: Eating disorder | |||
| Eu50100 | Read | [X]Atypical anorexia nervosa | diagnostic | res36: Eating disorder | |||
| Eu50200 | Read | [X]Bulimia nervosa | diagnostic | res36: Eating disorder | |||
| Eu50211 | Read | [X]Bulimia NOS | diagnostic | res36: Eating disorder | |||
| Eu50212 | Read | [X]Hyperorexia nervosa | diagnostic | res36: Eating disorder | |||
| Eu50300 | Read | [X]Atypical bulimia nervosa | diagnostic | res36: Eating disorder | |||
| Eu50400 | Read | [X]Overeating associated with other psychological disturbncs | diagnostic | res36: Eating disorder | |||
| Eu50411 | Read | [X]Psychogenic overeating | diagnostic | res36: Eating disorder | |||
| Eu50y00 | Read | [X]Other eating disorders | diagnostic | res36: Eating disorder | |||
| Eu50y11 | Read | [X]Pica in adults | diagnostic | res36: Eating disorder | |||
| Eu50z00 | Read | [X]Eating disorder, unspecified | diagnostic | res36: Eating disorder | |||
| Fy05.00 | Read | Nocturnal sleep-related eating disorder | diagnostic | res36: Eating disorder | |||
| R030.00 | Read | [D]Anorexia | diagnostic | res36: Eating disorder | |||
| R030z00 | Read | [D]Anorexia NOS | diagnostic | res36: Eating disorder | |||
| R036.00 | Read | [D]Polyphagia | diagnostic | res36: Eating disorder | |||
| R036000 | Read | [D]Excessive eating | diagnostic | res36: Eating disorder | |||
| R036011 | Read | [D]Bulimia NOS | diagnostic | res36: Eating disorder | |||
| R036100 | Read | [D]Hyperalimentation | diagnostic | res36: Eating disorder | |||
| R036z00 | Read | [D]Polyphagia NOS | diagnostic | res36: Eating disorder | |||
| SN42100 | Read | Starvation | diagnostic | res36: Eating disorder | |||
| U1B3.11 | Read | [X]Starvation | diagnostic | res36: Eating disorder | |||
| Z4B5.00 | Read | Eating disorder counselling | diagnostic | res36: Eating disorder | |||
| ZC2CD00 | Read | Dietary advice for eating disorder | diagnostic | res36: Eating disorder |
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