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Research article:
Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary care patients
Reference:
Kirsten Windfuhr, David While, Nav Kapur, Darren M. Ashcroft, Evangelos Kontopantelis, Matthew J. Carr, Jenny Shaw, Louis Appleby, Roger T. Webb (2016) Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary care patients. Psychological Medicine, doi:
- Link to article
- Abstract
- Background: Little is known about the precursors of suicide risk among primary care patients. Objectives: To examine risk of suicide in relation to recent general practice consultation patterns, psychiatric diagnoses and the prescribing of multiple psychotropic drug types. Methods: Nested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged 16 years and older who died by suicide during 2002-2011 (N=2384) were matched on gender, age and registered practice with up to 20 living control patients (N=46,899). Results: Risk of dying by suicide was raised among general practice non-attenders, and increased sharply with rising number of clinical consultations compared with patients who consulted once only in the year preceding suicide. Markedly elevated risk was also associated with the prescribing of multiple psychotropic medication types and with having several psychiatric diagnoses, and to a lesser degree risk was also raised among patients living in more socially deprived residential areas. In a multivariable model the confounding effect of multiple psychotropic drug types largely accounted for the rising risk gradient observed with increasing clinical consultation frequency. Conclusion: A greater proportion of patients with several psychiatric diagnoses, those prescribed multiple psychotropic medication types, and those who consult at very high frequency might be considered for referral to mental health services by their general practitioners. Non-attenders are also at increased risk, which suggests that conventional models of primary care may not be effective in meeting the needs of all people in the community experiencing major psychosocial difficulties and at elevated risk of suicide.
- Author for correspondence
- Roger Webb
- Email for correspondence
- roger.webb@manchester.ac.uk
Code list: res38: Atypical APDs
173 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 00209021 | Multilex | Quetiapine 12.5mg/5ml oral solution | drug | res38: Atypical APDs | |||
| 00337021 | Multilex | Asenapine 5mg sublingual tablets sugar free | drug | res38: Atypical APDs | |||
| 00341021 | Multilex | Asenapine 10mg sublingual tablets sugar free | drug | res38: Atypical APDs | |||
| 00411021 | Multilex | Amisulpride 25mg/5ml oral solution | drug | res38: Atypical APDs | |||
| 00447021 | Multilex | Quetiapine 12.5mg/5ml oral suspension | drug | res38: Atypical APDs | |||
| 00589021 | Multilex | Zalasta 5mg orodispersible tablets (Consilient Health Ltd) | drug | res38: Atypical APDs | |||
| 00709021 | Multilex | Olanzapine 5mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 00711021 | Multilex | Olanzapine 5mg orodispersible tablets | drug | res38: Atypical APDs | |||
| 00713021 | Multilex | Olanzapine 5mg oral lyophilisates sugar free | drug | res38: Atypical APDs | |||
| 00715021 | Multilex | Olanzapine 10mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 00717021 | Multilex | Olanzapine 10mg orodispersible tablets | drug | res38: Atypical APDs | |||
| 00719021 | Multilex | Olanzapine 10mg oral lyophilisates sugar free | drug | res38: Atypical APDs | |||
| 00723021 | Multilex | Olanzapine 15mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 00725021 | Multilex | Olanzapine 15mg orodispersible tablets | drug | res38: Atypical APDs | |||
| 00727021 | Multilex | Olanzapine 15mg oral lyophilisates sugar free | drug | res38: Atypical APDs | |||
| 00729021 | Multilex | Olanzapine 20mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 00731021 | Multilex | Olanzapine 20mg orodispersible tablets | drug | res38: Atypical APDs | |||
| 00733021 | Multilex | Olanzapine 20mg oral lyophilisates sugar free | drug | res38: Atypical APDs | |||
| 03580020 | Multilex | Olanzapine 2.5mg tablets (Aspire Pharma Ltd) | drug | res38: Atypical APDs | |||
| 10469020 | Multilex | Abilify 5mg tablets (Sigma Pharmaceuticals Plc) | drug | res38: Atypical APDs | |||
| 13768020 | Multilex | Risperdal Consta 50mg powder and solvent for suspension for injection vials (Waymade Healthcare Plc) | drug | res38: Atypical APDs | |||
| 33610020 | Multilex | Quetiapine 25mg/5ml oral solution | drug | res38: Atypical APDs | |||
| 35008020 | Multilex | Amisulpride 12.5mg/5ml oral solution | drug | res38: Atypical APDs | |||
| 35010020 | Multilex | Amisulpride 12.5mg/5ml oral suspension | drug | res38: Atypical APDs | |||
| 36328020 | Multilex | Quetiapine 50mg/5ml oral suspension | drug | res38: Atypical APDs | |||
| 36905020 | Multilex | Risperidone 125micrograms/5ml oral solution | drug | res38: Atypical APDs | |||
| 42176020 | Multilex | Quetiapine 25mg tablets (Zentiva) | drug | res38: Atypical APDs | |||
| 49437020 | Multilex | Risperdal 1mg tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 49438020 | Multilex | Risperdal 2mg tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 49439020 | Multilex | Risperdal 3mg tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 49489020 | Multilex | Risperidone 4mg tablets | drug | res38: Atypical APDs | |||
| 49490020 | Multilex | Risperidone 1mg/ml oral solution sugar free | drug | res38: Atypical APDs | |||
| 49491020 | Multilex | Risperidone 6mg tablets | drug | res38: Atypical APDs | |||
| 50780020 | Multilex | Zotepine 25mg tablets | drug | res38: Atypical APDs | |||
| 50781020 | Multilex | Zotepine 50mg tablets | drug | res38: Atypical APDs | |||
| 50782020 | Multilex | Zotepine 100mg tablets | drug | res38: Atypical APDs | |||
| 53727020 | Multilex | Risperidone 1mg tablets | drug | res38: Atypical APDs | |||
| 53728020 | Multilex | Risperidone 2mg tablets | drug | res38: Atypical APDs | |||
| 53729020 | Multilex | Risperidone 3mg tablets | drug | res38: Atypical APDs | |||
| 55209020 | Multilex | Zoleptil 25 tablets (Movianto UK Ltd) | drug | res38: Atypical APDs | |||
| 55210020 | Multilex | Zoleptil 50 tablets (Movianto UK Ltd) | drug | res38: Atypical APDs | |||
| 55972020 | Multilex | Olanzapine 15mg Orodispersible tablet | drug | res38: Atypical APDs | |||
| 58203020 | Multilex | Zyprexa 15mg tablets (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 59434020 | Multilex | Olanzapine 15mg tablets | drug | res38: Atypical APDs | |||
| 65788020 | Multilex | Risperidone 50mg powder and solvent for suspension for injection vials | drug | res38: Atypical APDs | |||
| 68217020 | Multilex | Amisulpride 50mg tablets (Zentiva) | drug | res38: Atypical APDs | |||
| 68222020 | Multilex | Amisulpride 100mg tablets (Zentiva) | drug | res38: Atypical APDs | |||
| 68224020 | Multilex | Amisulpride 200mg tablets (Zentiva) | drug | res38: Atypical APDs | |||
| 69302020 | Multilex | Amisulpride 200mg tablets (A A H Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 72576020 | Multilex | Clozaril 25mg tablets (Novartis Pharmaceuticals UK Ltd) | drug | res38: Atypical APDs | |||
| 72577020 | Multilex | Clozaril 100mg tablets (Novartis Pharmaceuticals UK Ltd) | drug | res38: Atypical APDs | |||
| 72580020 | Multilex | Clozapine 25mg tablets | drug | res38: Atypical APDs | |||
| 72581020 | Multilex | Clozapine 100mg tablets | drug | res38: Atypical APDs | |||
| 73439020 | Multilex | Remoxipride 150mg capsule | drug | res38: Atypical APDs | |||
| 73440020 | Multilex | Remoxipride 300mg capsule | drug | res38: Atypical APDs | |||
| 73441020 | Multilex | Remoxipride 75mg capsule | drug | res38: Atypical APDs | |||
| 73474020 | Multilex | Roxiam 150mg Capsule (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 73475020 | Multilex | Roxiam 300mg Capsule (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 73798020 | Multilex | Risperdal 4mg tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 73799020 | Multilex | Risperdal 1mg/ml liquid (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 73800020 | Multilex | Risperdal 6mg tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 74786020 | Multilex | Risperidone 500microgram tablets (Actavis UK Ltd) | drug | res38: Atypical APDs | |||
| 74841020 | Multilex | Risperidone 1mg tablets (Teva UK Ltd) | drug | res38: Atypical APDs | |||
| 74927020 | Multilex | Risperidone 500microgram tablets (A A H Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 77501020 | Multilex | Risperdal Quicklet 2mg orodispersible tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 77550020 | Multilex | Risperdal Consta 37.5mg powder and solvent for suspension for injection vials (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 77749020 | Multilex | Risperdal 500microgram tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 77912020 | Multilex | Risperidone 500microgram tablets | drug | res38: Atypical APDs | |||
| 78753020 | Multilex | Risperdal Consta 25mg powder and solvent for suspension for injection vials (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 78912020 | Multilex | Zyprexa 5mg Velotabs (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 78913020 | Multilex | Zyprexa 10mg Velotabs (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 79348020 | Multilex | Solian 100mg/ml oral solution (Sanofi) | drug | res38: Atypical APDs | |||
| 79476020 | Multilex | Risperidone 1mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 79499020 | Multilex | Zyprexa 15mg Velotabs (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 80139020 | Multilex | Amisulpride 100mg tablets | drug | res38: Atypical APDs | |||
| 80154020 | Multilex | Solian 100 tablets (Sanofi) | drug | res38: Atypical APDs | |||
| 81008020 | Multilex | Zyprexa 2.5mg tablets (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 81014020 | Multilex | Olanzapine 2.5mg tablets | drug | res38: Atypical APDs | |||
| 81015020 | Multilex | Olanzapine 5mg Orodispersible tablet | drug | res38: Atypical APDs | |||
| 81016020 | Multilex | Olanzapine 10mg Orodispersible tablet | drug | res38: Atypical APDs | |||
| 81543020 | Multilex | Risperidone 2mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 81545020 | Multilex | Risperdal Quicklet 1mg orodispersible tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 81945020 | Multilex | Amisulpride 100mg/ml oral solution sugar free | drug | res38: Atypical APDs | |||
| 82616020 | Multilex | Risperdal Consta 50mg powder and solvent for suspension for injection vials (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 82827020 | Multilex | Sertindole 4mg tablets | drug | res38: Atypical APDs | |||
| 82828020 | Multilex | Sertindole 12mg tablets | drug | res38: Atypical APDs | |||
| 82829020 | Multilex | Sertindole 16mg tablets | drug | res38: Atypical APDs | |||
| 82831020 | Multilex | Sertindole 20mg tablets | drug | res38: Atypical APDs | |||
| 82835020 | Multilex | Serdolect 4mg tablets (Lundbeck Ltd) | drug | res38: Atypical APDs | |||
| 82836020 | Multilex | Serdolect 12mg tablets (Lundbeck Ltd) | drug | res38: Atypical APDs | |||
| 82837020 | Multilex | Serdolect 16mg tablets (Lundbeck Ltd) | drug | res38: Atypical APDs | |||
| 83397020 | Multilex | Zyprexa 5mg tablets (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 83398020 | Multilex | Zyprexa 7.5mg tablets (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 83399020 | Multilex | Zyprexa 10mg tablets (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 83403020 | Multilex | Olanzapine 5mg tablets | drug | res38: Atypical APDs | |||
| 83404020 | Multilex | Olanzapine 7.5mg tablets | drug | res38: Atypical APDs | |||
| 83405020 | Multilex | Olanzapine 10mg tablets | drug | res38: Atypical APDs | |||
| 84528020 | Multilex | Roxiam ir 75mg Capsule (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 85202020 | Multilex | Quetiapine Starter Pack | drug | res38: Atypical APDs | |||
| 85203020 | Multilex | Quetiapine 25mg tablets | drug | res38: Atypical APDs | |||
| 85204020 | Multilex | Quetiapine 100mg tablets | drug | res38: Atypical APDs | |||
| 85206020 | Multilex | Quetiapine 200mg tablets | drug | res38: Atypical APDs | |||
| 85207020 | Multilex | Quetiapine 150mg tablets | drug | res38: Atypical APDs | |||
| 85212020 | Multilex | Seroquel 25mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 85213020 | Multilex | Seroquel 100mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 85215020 | Multilex | Seroquel 200mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 85216020 | Multilex | Seroquel 150mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 85992020 | Multilex | Amisulpride 50mg tablets | drug | res38: Atypical APDs | |||
| 85993020 | Multilex | Amisulpride 200mg tablets | drug | res38: Atypical APDs | |||
| 85994020 | Multilex | Amisulpride 400mg tablets | drug | res38: Atypical APDs | |||
| 85999020 | Multilex | Solian 50 tablets (Sanofi) | drug | res38: Atypical APDs | |||
| 86000020 | Multilex | Solian 200 tablets (Sanofi) | drug | res38: Atypical APDs | |||
| 86001020 | Multilex | Solian 400 tablets (Sanofi) | drug | res38: Atypical APDs | |||
| 86494020 | Multilex | Risperidone 25mg powder and solvent for suspension for injection vials | drug | res38: Atypical APDs | |||
| 86496020 | Multilex | Risperidone 37.5mg powder and solvent for suspension for injection vials | drug | res38: Atypical APDs | |||
| 87045020 | Multilex | Quetiapine 300mg tablets | drug | res38: Atypical APDs | |||
| 87047020 | Multilex | Seroquel 300mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 87556020 | Multilex | Olanzapine 10mg powder for solution for injection vials | drug | res38: Atypical APDs | |||
| 87558020 | Multilex | Zyprexa 10mg powder for solution for injection vials (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 87944020 | Multilex | Aripiprazole 10mg tablets | drug | res38: Atypical APDs | |||
| 87946020 | Multilex | Aripiprazole 15mg tablets | drug | res38: Atypical APDs | |||
| 87948020 | Multilex | Aripiprazole 30mg tablets | drug | res38: Atypical APDs | |||
| 87950020 | Multilex | Abilify 10mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 87952020 | Multilex | Abilify 15mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 87954020 | Multilex | Abilify 30mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 88167020 | Multilex | Denzapine 25mg tablets (Britannia Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 88169020 | Multilex | Denzapine 100mg tablets (Britannia Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 88666020 | Multilex | Aripiprazole 5mg tablets | drug | res38: Atypical APDs | |||
| 88668020 | Multilex | Abilify 5mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 88804020 | Multilex | Zaponex 25mg tablets (Teva UK Ltd) | drug | res38: Atypical APDs | |||
| 88806020 | Multilex | Zaponex 100mg tablets (Teva UK Ltd) | drug | res38: Atypical APDs | |||
| 88875020 | Multilex | Risperidone 500microgram orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 88877020 | Multilex | Risperdal Quicklet 500microgram orodispersible tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 89950020 | Multilex | Amisulpride 25mg/5ml oral suspension | drug | res38: Atypical APDs | |||
| 90165020 | Multilex | Olanzapine 20mg Orodispersible tablet | drug | res38: Atypical APDs | |||
| 90167020 | Multilex | Zyprexa 20mg Velotabs (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 91139020 | Multilex | Aripiprazole 10mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 91141020 | Multilex | Aripiprazole 15mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 91143020 | Multilex | Aripiprazole 1mg/ml oral solution | drug | res38: Atypical APDs | |||
| 91145020 | Multilex | Abilify 10mg orodispersible tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 91147020 | Multilex | Abilify 15mg orodispersible tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 91149020 | Multilex | Abilify 1mg/ml oral solution (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 92053020 | Multilex | Olanzapine 20mg tablets | drug | res38: Atypical APDs | |||
| 92055020 | Multilex | Zyprexa 20mg tablets (Eli Lilly and Company Ltd) | drug | res38: Atypical APDs | |||
| 92717020 | Multilex | Risperidone 3mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 92721020 | Multilex | Risperidone 4mg orodispersible tablets sugar free | drug | res38: Atypical APDs | |||
| 92723020 | Multilex | Risperdal Quicklet 3mg orodispersible tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 92725020 | Multilex | Risperdal Quicklet 4mg orodispersible tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 93739020 | Multilex | Paliperidone 3mg modified-release tablets | drug | res38: Atypical APDs | |||
| 93741020 | Multilex | Paliperidone 6mg modified-release tablets | drug | res38: Atypical APDs | |||
| 93743020 | Multilex | Paliperidone 9mg modified-release tablets | drug | res38: Atypical APDs | |||
| 93747020 | Multilex | Invega 6mg modified-release tablets (Janssen-Cilag Ltd) | drug | res38: Atypical APDs | |||
| 94787020 | Multilex | Quetiapine 50mg modified-release tablets | drug | res38: Atypical APDs | |||
| 94789020 | Multilex | Quetiapine 200mg modified-release tablets | drug | res38: Atypical APDs | |||
| 94791020 | Multilex | Quetiapine 300mg modified-release tablets | drug | res38: Atypical APDs | |||
| 94793020 | Multilex | Quetiapine 400mg modified-release tablets | drug | res38: Atypical APDs | |||
| 94971020 | Multilex | Aripiprazole 9.75mg/1.3ml solution for injection vials | drug | res38: Atypical APDs | |||
| 94973020 | Multilex | Abilify 9.75mg/1.3ml solution for injection vials (Otsuka Pharmaceuticals (U.K.) Ltd) | drug | res38: Atypical APDs | |||
| 95787020 | Multilex | Seroquel XL 50mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 95789020 | Multilex | Seroquel XL 200mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 95791020 | Multilex | Seroquel XL 300mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 95793020 | Multilex | Seroquel XL 400mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 97145020 | Multilex | Clozapine 50mg tablets | drug | res38: Atypical APDs | |||
| 97147020 | Multilex | Denzapine 50mg tablets (Britannia Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 97149020 | Multilex | Clozapine 200mg tablets | drug | res38: Atypical APDs | |||
| 97151020 | Multilex | Denzapine 200mg tablets (Britannia Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 97153020 | Multilex | Clozapine 50mg/ml oral suspension sugar free | drug | res38: Atypical APDs | |||
| 97155020 | Multilex | Denzapine 50mg/ml oral suspension (Britannia Pharmaceuticals Ltd) | drug | res38: Atypical APDs | |||
| 97203020 | Multilex | Quetiapine 100mg/5ml oral solution | drug | res38: Atypical APDs | |||
| 97205020 | Multilex | Quetiapine 100mg/5ml oral suspension | drug | res38: Atypical APDs | |||
| 98873020 | Multilex | Quetiapine 150mg modified-release tablets | drug | res38: Atypical APDs | |||
| 98875020 | Multilex | Seroquel XL 150mg tablets (AstraZeneca UK Ltd) | drug | res38: Atypical APDs | |||
| 99745020 | Multilex | Quetiapine 25mg/5ml oral suspension | drug | res38: Atypical APDs |
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