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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: Depot APDs
56 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 48900020 | Multilex | Depixol -conc 100mg/ml Injection (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 50445020 | Multilex | Modecate 25mg/ml Injection (Sanofi-Synthelabo Ltd) | drug | res38: Depot APDs | |||
| 53027020 | Multilex | Clopixol 200mg/ml Oily injection (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 53030020 | Multilex | Depixol 20mg/ml Injection (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 53031020 | Multilex | Depixol 40mg/2ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 53053020 | Multilex | Modecate concentrate 100mg/ml Injection (Sanofi-Synthelabo Ltd) | drug | res38: Depot APDs | |||
| 53586020 | Multilex | Piportil 50mg/ml Depot injection (JHC Healthcare Ltd) | drug | res38: Depot APDs | |||
| 57938020 | Multilex | Depixol Low Volume 200mg/1ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 58509020 | Multilex | Haldol decanoate 50mg/1ml solution for injection ampoules (Janssen-Cilag Ltd) | drug | res38: Depot APDs | |||
| 58510020 | Multilex | Haldol decanoate 100mg/1ml solution for injection ampoules (Janssen-Cilag Ltd) | drug | res38: Depot APDs | |||
| 61027020 | Multilex | Fluphenazine decanoate 25mg/1ml solution for injection ampoules (Hospira UK Ltd) | drug | res38: Depot APDs | |||
| 61511020 | Multilex | Zuclopenthixol decanoate 200mg/ml oily injection | drug | res38: Depot APDs | |||
| 61512020 | Multilex | Zuclopenthixol decanoate 500mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 62032020 | Multilex | Flupentixol decanoate 20mg/ml Injection | drug | res38: Depot APDs | |||
| 62033020 | Multilex | Flupentixol decanoate 100mg/ml Injection | drug | res38: Depot APDs | |||
| 62034020 | Multilex | Flupentixol 200mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 62048020 | Multilex | Fluphenazine decanoate 25mg/ml Injection | drug | res38: Depot APDs | |||
| 62049020 | Multilex | Fluphenazine decanoate 100mg/ml Injection | drug | res38: Depot APDs | |||
| 62954020 | Multilex | Fluphenazine decanoate 25mg/ml Injection (Antigen Pharmaceuticals) | drug | res38: Depot APDs | |||
| 63123020 | Multilex | Haloperidol decanoate 50mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 63124020 | Multilex | Haloperidol decanoate 100mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 65842020 | Multilex | Pipotiazine palmitate 50mg/ml depot injection | drug | res38: Depot APDs | |||
| 67405020 | Multilex | Clopixol Conc 500mg/1ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 68096020 | Multilex | Flupentixol 40mg/2ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 89970020 | Multilex | Flupentixol 50mg/0.5ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 89972020 | Multilex | Flupentixol 100mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 89974020 | Multilex | Depixol Conc 50mg/0.5ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 89976020 | Multilex | Depixol Conc 100mg/1ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 91582020 | Multilex | Flupentixol 20mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 91584020 | Multilex | Depixol 20mg/1ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 91592020 | Multilex | Zuclopenthixol decanoate 200mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 91596020 | Multilex | Clopixol 200mg/1ml solution for injection ampoules (Lundbeck Ltd) | drug | res38: Depot APDs | |||
| 91981020 | Multilex | Pipotiazine 50mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 91985020 | Multilex | Pipotiazine 100mg/2ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 91987020 | Multilex | Piportil Depot 50mg/1ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 91989020 | Multilex | Piportil Depot 100mg/2ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 92200020 | Multilex | Fluphenazine decanoate 12.5mg/0.5ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 92202020 | Multilex | Fluphenazine decanoate 25mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 92204020 | Multilex | Fluphenazine decanoate 50mg/2ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 92206020 | Multilex | Modecate 12.5mg/0.5ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 92208020 | Multilex | Modecate 25mg/1ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 92210020 | Multilex | Modecate 50mg/2ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 92212020 | Multilex | Fluphenazine decanoate 50mg/0.5ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 92214020 | Multilex | Fluphenazine decanoate 100mg/1ml solution for injection ampoules | drug | res38: Depot APDs | |||
| 92216020 | Multilex | Modecate Concentrate 50mg/0.5ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 92218020 | Multilex | Modecate Concentrate 100mg/1ml solution for injection ampoules (Sanofi) | drug | res38: Depot APDs | |||
| 98278020 | Multilex | Olanzapine embonate 210mg powder and solvent for suspension for injection vials | drug | res38: Depot APDs | |||
| 98329020 | Multilex | Olanzapine embonate 300mg powder and solvent for suspension for injection vials | drug | res38: Depot APDs | |||
| 99841020 | Multilex | Paliperidone 50mg/0.5ml suspension for injection pre-filled syringes | drug | res38: Depot APDs | |||
| 99843020 | Multilex | Paliperidone 75mg/0.75ml suspension for injection pre-filled syringes | drug | res38: Depot APDs | |||
| 99845020 | Multilex | Paliperidone 100mg/1ml suspension for injection pre-filled syringes | drug | res38: Depot APDs | |||
| 99847020 | Multilex | Paliperidone 150mg/1.5ml suspension for injection pre-filled syringes | drug | res38: Depot APDs | |||
| 99849020 | Multilex | Xeplion 50mg/0.5ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd) | drug | res38: Depot APDs | |||
| 99851020 | Multilex | Xeplion 75mg/0.75ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd) | drug | res38: Depot APDs | |||
| 99853020 | Multilex | Xeplion 100mg/1ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd) | drug | res38: Depot APDs | |||
| 99855020 | Multilex | Xeplion 150mg/1.5ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd) | drug | res38: Depot APDs |
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