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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: Other ADDs
128 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 03818020 | Multilex | Fluanxol 1mg tablets (Sigma Pharmaceuticals Plc) | drug | res38: Other ADDs | |||
| 03942020 | Multilex | Venlafaxine 37.5mg tablets (Ranbaxy (UK) Ltd) | drug | res38: Other ADDs | |||
| 03965020 | Multilex | Venlablue XL 75mg capsules (Bluefish Pharmaceuticals AB) | drug | res38: Other ADDs | |||
| 03966020 | Multilex | Alventa XL 75mg capsules (Consilient Health Ltd) | drug | res38: Other ADDs | |||
| 03970020 | Multilex | Efexor XL 150mg capsules (Waymade Healthcare Plc) | drug | res38: Other ADDs | |||
| 03976020 | Multilex | Venlablue XL 150mg capsules (Bluefish Pharmaceuticals AB) | drug | res38: Other ADDs | |||
| 03977020 | Multilex | Alventa XL 150mg capsules (Consilient Health Ltd) | drug | res38: Other ADDs | |||
| 09892020 | Multilex | Zispin SolTab 15mg orodispersible tablets (Necessity Supplies Ltd) | drug | res38: Other ADDs | |||
| 09905020 | Multilex | Zispin SolTab 30mg orodispersible tablets (Necessity Supplies Ltd) | drug | res38: Other ADDs | |||
| 10967020 | Multilex | Duloxetine 60mg gastro-resistant capsules (Sigma Pharmaceuticals Plc) | drug | res38: Other ADDs | |||
| 21206020 | Multilex | Mirtazapine 15mg/ml oral solution sugar free (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 35355020 | Multilex | Venlafaxine 150mg/5ml oral solution | drug | res38: Other ADDs | |||
| 35357020 | Multilex | Venlafaxine 37.5mg/5ml oral solution | drug | res38: Other ADDs | |||
| 35359020 | Multilex | Venlafaxine 75mg/5ml oral solution | drug | res38: Other ADDs | |||
| 38595020 | Multilex | Mirtazapine 15mg tablets (Medreich Plc) | drug | res38: Other ADDs | |||
| 41252020 | Multilex | Mirtazapine 15mg orodispersible tablets sugar free | drug | res38: Other ADDs | |||
| 41253020 | Multilex | Mirtazapine 15mg orodispersible tablets sugar free (Sandoz Ltd) | drug | res38: Other ADDs | |||
| 41254020 | Multilex | Mirtazapine 45mg orodispersible tablets sugar free | drug | res38: Other ADDs | |||
| 48376020 | Multilex | Efexor 37.5mg tablets (Wyeth Pharmaceuticals) | drug | res38: Other ADDs | |||
| 48377020 | Multilex | Efexor 75mg tablets (Wyeth Pharmaceuticals) | drug | res38: Other ADDs | |||
| 49502020 | Multilex | Fluanxol 500microgram tablets (Lundbeck Ltd) | drug | res38: Other ADDs | |||
| 49503020 | Multilex | Fluanxol 1mg tablets (Lundbeck Ltd) | drug | res38: Other ADDs | |||
| 50286020 | Multilex | Marplan 10mg Tablet (Cambridge Laboratories Ltd) | drug | res38: Other ADDs | |||
| 50620020 | Multilex | Nardil 15mg tablets (Archimedes Pharma UK Ltd) | drug | res38: Other ADDs | |||
| 50868020 | Multilex | Optimax 500mg tablets (Merck Serono Ltd) | drug | res38: Other ADDs | |||
| 50957020 | Multilex | Pacitron 500mg Tablet (Rorer Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 51010020 | Multilex | Parnate 10mg Tablet (Goldshield Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 51013020 | Multilex | Parstelin Tablet (GlaxoSmithKline Consumer Healthcare) | drug | res38: Other ADDs | |||
| 54686020 | Multilex | Venlafaxine 37.5mg tablets | drug | res38: Other ADDs | |||
| 54687020 | Multilex | Venlafaxine 75mg tablets | drug | res38: Other ADDs | |||
| 54978020 | Multilex | Optimax wv Tablet (E. Merck) | drug | res38: Other ADDs | |||
| 59180020 | Multilex | Isocarboxazid 10mg Tablet (Cambridge Laboratories Ltd) | drug | res38: Other ADDs | |||
| 62025020 | Multilex | Flupentixol 500microgram tablets | drug | res38: Other ADDs | |||
| 62026020 | Multilex | Flupentixol 1mg tablets | drug | res38: Other ADDs | |||
| 63638020 | Multilex | Isocarboxazid 10mg tablets | drug | res38: Other ADDs | |||
| 63795020 | Multilex | Moclobemide 150mg tablets (Teva UK Ltd) | drug | res38: Other ADDs | |||
| 65266020 | Multilex | Tranylcypromine 10mg tablets (AMCo) | drug | res38: Other ADDs | |||
| 65635020 | Multilex | Phenelzine 15mg tablets | drug | res38: Other ADDs | |||
| 67145020 | Multilex | Tranylcypromine 10mg tablets | drug | res38: Other ADDs | |||
| 67148020 | Multilex | Tranylcypromine with trifluoperazine Tablet | drug | res38: Other ADDs | |||
| 67310020 | Multilex | Tryptophan 500mg tablets | drug | res38: Other ADDs | |||
| 67314020 | Multilex | Tryptophan with ascorbic acid and pyridoxine powder | drug | res38: Other ADDs | |||
| 68128020 | Multilex | Mirtazapine 15mg/ml oral solution sugar free (Rosemont Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 68213020 | Multilex | Mirtazapine 30mg tablets (Actavis UK Ltd) | drug | res38: Other ADDs | |||
| 68484020 | Multilex | Mirtazapine 30mg tablets (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 69003020 | Multilex | Trifluoperazine with tranylcypromine 1mg + 10mg Tablet | drug | res38: Other ADDs | |||
| 69827020 | Multilex | Mirtazapine 15mg tablets (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 69832020 | Multilex | Mirtazapine 45mg tablets (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 70353020 | Multilex | Mirtazapine 15mg tablets (Arrow Generics Ltd) | drug | res38: Other ADDs | |||
| 71074020 | Multilex | Mirtazapine 15mg tablets (Genus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 71994020 | Multilex | Manerix 150mg tablets (Meda Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 71995020 | Multilex | Manerix 300mg tablets (Meda Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 72031020 | Multilex | Moclobemide 150mg tablets | drug | res38: Other ADDs | |||
| 72032020 | Multilex | Moclobemide 300mg tablets | drug | res38: Other ADDs | |||
| 74026020 | Multilex | Mirtazapine 15mg orodispersible tablets (Teva UK Ltd) | drug | res38: Other ADDs | |||
| 74033020 | Multilex | Mirtazapine 45mg orodispersible tablets (Teva UK Ltd) | drug | res38: Other ADDs | |||
| 74665020 | Multilex | Mirtazapine 30mg orodispersible tablets (Actavis UK Ltd) | drug | res38: Other ADDs | |||
| 74668020 | Multilex | Mirtazapine 45mg orodispersible tablets (Actavis UK Ltd) | drug | res38: Other ADDs | |||
| 74684020 | Multilex | Mirtazapine 15mg orodispersible tablets (Focus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 74689020 | Multilex | Mirtazapine 45mg orodispersible tablets (Focus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 74702020 | Multilex | Mirtazapine 15mg orodispersible tablets (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 74705020 | Multilex | Mirtazapine 30mg orodispersible tablets (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 74708020 | Multilex | Mirtazapine 45mg orodispersible tablets (A A H Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 74967020 | Multilex | Mirtazapine 15mg orodispersible tablets (Genus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 74977020 | Multilex | Mirtazapine 45mg orodispersible tablets (Genus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 75309020 | Multilex | Mirtazapine 15mg tablets (Teva UK Ltd) | drug | res38: Other ADDs | |||
| 76425020 | Multilex | Mirtazapine 15mg tablets (Actavis UK Ltd) | drug | res38: Other ADDs | |||
| 76512020 | Multilex | Mirtazapine 15mg orodispersible tablets (Aurobindo Pharma Ltd) | drug | res38: Other ADDs | |||
| 78577020 | Multilex | Mirtazapine 30mg orodispersible tablets (Almus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 84955020 | Multilex | Reboxetine 4mg tablets | drug | res38: Other ADDs | |||
| 84961020 | Multilex | Edronax 4mg tablets (Pfizer Ltd) | drug | res38: Other ADDs | |||
| 85108020 | Multilex | Venlafaxine 75mg modified-release capsules | drug | res38: Other ADDs | |||
| 85109020 | Multilex | Venlafaxine 150mg modified-release capsules | drug | res38: Other ADDs | |||
| 85163020 | Multilex | Efexor XL 75mg capsules (Pfizer Ltd) | drug | res38: Other ADDs | |||
| 85164020 | Multilex | Efexor XL 150mg capsules (Pfizer Ltd) | drug | res38: Other ADDs | |||
| 85247020 | Multilex | Mirtazapine 30mg tablets | drug | res38: Other ADDs | |||
| 85251020 | Multilex | Zispin 30mg tablets (Organon Laboratories Ltd) | drug | res38: Other ADDs | |||
| 86969020 | Multilex | Mirtazapine 30mg orodispersible tablets | drug | res38: Other ADDs | |||
| 86971020 | Multilex | Zispin SolTab 30mg orodispersible tablets (Merck Sharp & Dohme Ltd) | drug | res38: Other ADDs | |||
| 87476020 | Multilex | Mirtazapine 15mg orodispersible tablets | drug | res38: Other ADDs | |||
| 87478020 | Multilex | Mirtazapine 45mg orodispersible tablets | drug | res38: Other ADDs | |||
| 87480020 | Multilex | Zispin SolTab 15mg orodispersible tablets (Merck Sharp & Dohme Ltd) | drug | res38: Other ADDs | |||
| 87482020 | Multilex | Zispin SolTab 45mg orodispersible tablets (Merck Sharp & Dohme Ltd) | drug | res38: Other ADDs | |||
| 87990020 | Multilex | Mirtazapine 15mg/ml oral solution sugar free | drug | res38: Other ADDs | |||
| 88845020 | Multilex | Duloxetine 30mg gastro-resistant capsules | drug | res38: Other ADDs | |||
| 88847020 | Multilex | Duloxetine 60mg gastro-resistant capsules | drug | res38: Other ADDs | |||
| 88849020 | Multilex | Cymbalta 30mg gastro-resistant capsules (Eli Lilly and Company Ltd) | drug | res38: Other ADDs | |||
| 88851020 | Multilex | Cymbalta 60mg gastro-resistant capsules (Eli Lilly and Company Ltd) | drug | res38: Other ADDs | |||
| 88879020 | Multilex | Mirtazapine 15mg tablets | drug | res38: Other ADDs | |||
| 88881020 | Multilex | Mirtazapine 45mg tablets | drug | res38: Other ADDs | |||
| 89954020 | Multilex | Venlafaxine 37.5mg/5ml oral suspension | drug | res38: Other ADDs | |||
| 96239020 | Multilex | Rodomel XL 75mg capsules (Teva UK Ltd) | drug | res38: Other ADDs | |||
| 96241020 | Multilex | Rodomel XL 150mg capsules (Teva UK Ltd) | drug | res38: Other ADDs | |||
| 96329020 | Multilex | Tardcaps XL 75mg capsules (IXL Pharma Ltd) | drug | res38: Other ADDs | |||
| 96331020 | Multilex | Tardcaps XL 150mg capsules (IXL Pharma Ltd) | drug | res38: Other ADDs | |||
| 96355020 | Multilex | Vensir XL 75mg capsules (Morningside Healthcare Ltd) | drug | res38: Other ADDs | |||
| 96357020 | Multilex | Vensir XL 150mg capsules (Morningside Healthcare Ltd) | drug | res38: Other ADDs | |||
| 96439020 | Multilex | ViePax 37.5mg tablets (Dexcel-Pharma Ltd) | drug | res38: Other ADDs | |||
| 96441020 | Multilex | ViePax 75mg tablets (Dexcel-Pharma Ltd) | drug | res38: Other ADDs | |||
| 96445020 | Multilex | Venlafaxine 75mg modified-release tablets | drug | res38: Other ADDs | |||
| 96447020 | Multilex | Venlafaxine 150mg modified-release tablets | drug | res38: Other ADDs | |||
| 96449020 | Multilex | ViePax XL 75mg tablets (Dexcel-Pharma Ltd) | drug | res38: Other ADDs | |||
| 96451020 | Multilex | ViePax XL 150mg tablets (Dexcel-Pharma Ltd) | drug | res38: Other ADDs | |||
| 96465020 | Multilex | Tifaxin XL 75mg capsules (Genus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 96467020 | Multilex | Tifaxin XL 150mg capsules (Genus Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 96473020 | Multilex | Politid XL 75mg capsules (Actavis UK Ltd) | drug | res38: Other ADDs | |||
| 96475020 | Multilex | Politid XL 150mg capsules (Actavis UK Ltd) | drug | res38: Other ADDs | |||
| 96534020 | Multilex | Vexarin XL 75mg capsules (Generics (UK) Ltd) | drug | res38: Other ADDs | |||
| 96536020 | Multilex | Vexarin XL 150mg capsules (Generics (UK) Ltd) | drug | res38: Other ADDs | |||
| 96614020 | Multilex | Venlafaxine 75mg modified-release capsules (Sandoz Ltd) | drug | res38: Other ADDs | |||
| 96616020 | Multilex | Venlafaxine 150mg modified-release capsules (Sandoz Ltd) | drug | res38: Other ADDs | |||
| 96834020 | Multilex | Venlalic XL 75mg tablets (DB Ashbourne Ltd) | drug | res38: Other ADDs | |||
| 96836020 | Multilex | Venlalic XL 150mg tablets (DB Ashbourne Ltd) | drug | res38: Other ADDs | |||
| 96838020 | Multilex | Venlafaxine 225mg modified-release tablets | drug | res38: Other ADDs | |||
| 96841020 | Multilex | Venlalic XL 225mg tablets (DB Ashbourne Ltd) | drug | res38: Other ADDs | |||
| 97003020 | Multilex | Venaxx XL 75mg capsules (AMCo) | drug | res38: Other ADDs | |||
| 97005020 | Multilex | Venaxx XL 150mg capsules (AMCo) | drug | res38: Other ADDs | |||
| 97028020 | Multilex | Agomelatine 25mg tablets | drug | res38: Other ADDs | |||
| 97030020 | Multilex | Valdoxan 25mg tablets (Servier Laboratories Ltd) | drug | res38: Other ADDs | |||
| 97351020 | Multilex | Foraven XL 75mg capsules (Forum Products Ltd) | drug | res38: Other ADDs | |||
| 97656020 | Multilex | Ranfaxine XL 75mg capsules (Ranbaxy (UK) Ltd) | drug | res38: Other ADDs | |||
| 98348020 | Multilex | Tonpular XL 75mg capsules (Wockhardt UK Ltd) | drug | res38: Other ADDs | |||
| 98861020 | Multilex | Depefex XL 75mg capsules (Chiesi Ltd) | drug | res38: Other ADDs | |||
| 98863020 | Multilex | Depefex XL 150mg capsules (Chiesi Ltd) | drug | res38: Other ADDs | |||
| 99208020 | Multilex | Venlaneo XL 75mg capsules (Kent Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 99210020 | Multilex | Venlaneo XL 150mg capsules (Kent Pharmaceuticals Ltd) | drug | res38: Other ADDs | |||
| 99679020 | Multilex | Venlafaxine 37.5mg modified-release tablets | drug | res38: Other ADDs | |||
| 99681020 | Multilex | Venlalic XL 37.5mg tablets (DB Ashbourne Ltd) | drug | res38: Other ADDs |
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