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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: Personality disorder
78 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| E21..00 | Read | Personality disorders | diagnostic | res38: Personality disorder | |||
| E210.00 | Read | Paranoid personality disorder | diagnostic | res38: Personality disorder | |||
| E211.00 | Read | Affective personality disorder | diagnostic | res38: Personality disorder | |||
| E211000 | Read | Unspecified affective personality disorder | diagnostic | res38: Personality disorder | |||
| E21..11 | Read | Neurotic personality disorder | diagnostic | res38: Personality disorder | |||
| E211100 | Read | Hypomanic personality disorder | diagnostic | res38: Personality disorder | |||
| E211200 | Read | Depressive personality disorder | diagnostic | res38: Personality disorder | |||
| E211300 | Read | Cyclothymic personality disorder | diagnostic | res38: Personality disorder | |||
| E211z00 | Read | Affective personality disorder NOS | diagnostic | res38: Personality disorder | |||
| E212.00 | Read | Schizoid personality disorder | diagnostic | res38: Personality disorder | |||
| E212000 | Read | Unspecified schizoid personality disorder | diagnostic | res38: Personality disorder | |||
| E212z00 | Read | Schizoid personality disorder NOS | diagnostic | res38: Personality disorder | |||
| E213.00 | Read | Explosive personality disorder | diagnostic | res38: Personality disorder | |||
| E214.00 | Read | Compulsive personality disorders | diagnostic | res38: Personality disorder | |||
| E214000 | Read | Anankastic personality | diagnostic | res38: Personality disorder | |||
| E214.11 | Read | Anancastic personality | diagnostic | res38: Personality disorder | |||
| E214z00 | Read | Compulsive personality disorder NOS | diagnostic | res38: Personality disorder | |||
| E215.00 | Read | Histrionic personality disorders | diagnostic | res38: Personality disorder | |||
| E215000 | Read | Unspecified histrionic personality disorder | diagnostic | res38: Personality disorder | |||
| E215.11 | Read | Hysterical personality disorders | diagnostic | res38: Personality disorder | |||
| E215z00 | Read | Histrionic personality disorder NOS | diagnostic | res38: Personality disorder | |||
| E216.00 | Read | Inadequate personality disorder | diagnostic | res38: Personality disorder | |||
| E217.00 | Read | Antisocial or sociopathic personality disorder | diagnostic | res38: Personality disorder | |||
| E21y.00 | Read | Other personality disorders | diagnostic | res38: Personality disorder | |||
| E21y000 | Read | Narcissistic personality disorder | diagnostic | res38: Personality disorder | |||
| E21y100 | Read | Avoidant personality disorder | diagnostic | res38: Personality disorder | |||
| E21y200 | Read | Borderline personality disorder | diagnostic | res38: Personality disorder | |||
| E21y300 | Read | Passive-aggressive personality disorder | diagnostic | res38: Personality disorder | |||
| E21y400 | Read | Eccentric personality disorder | diagnostic | res38: Personality disorder | |||
| E21y500 | Read | Immature personality disorder | diagnostic | res38: Personality disorder | |||
| E21y600 | Read | Masochistic personality disorder | diagnostic | res38: Personality disorder | |||
| E21y700 | Read | Psychoneurotic personality disorder | diagnostic | res38: Personality disorder | |||
| E21yz00 | Read | Other personality disorder NOS | diagnostic | res38: Personality disorder | |||
| E21z.00 | Read | Personality disorder NOS | diagnostic | res38: Personality disorder | |||
| E21z.11 | Read | Psychopathic personality | diagnostic | res38: Personality disorder | |||
| Eu06000 | Read | [X]Organic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu06011 | Read | [X]Organic pseudopsychopathic personality | diagnostic | res38: Personality disorder | |||
| Eu21.17 | Read | [X]Pseudopsychopathic schizophrenia | diagnostic | res38: Personality disorder | |||
| Eu21.18 | Read | [X]Schizotypal personality disorder | diagnostic | res38: Personality disorder | |||
| Eu34011 | Read | [X]Affective personality disorder | diagnostic | res38: Personality disorder | |||
| Eu34112 | Read | [X]Depressive personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60.00 | Read | [X]Specific personality disorders | diagnostic | res38: Personality disorder | |||
| Eu60000 | Read | [X]Paranoid personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60013 | Read | [X]Querulant personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60014 | Read | [X]Sensitive paranoid personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60100 | Read | [X]Schizoid personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60200 | Read | [X]Dissocial personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60212 | Read | [X]Antisocial personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60213 | Read | [X]Asocial personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60214 | Read | [X]Psychopathic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60215 | Read | [X]Sociopathic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60300 | Read | [X]Emotionally unstable personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60311 | Read | [X]Aggressive personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60312 | Read | [X]Borderline personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60313 | Read | [X]Explosive personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60400 | Read | [X]Histrionic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60411 | Read | [X]Hysterical personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60412 | Read | [X]Psychoinfantile personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60500 | Read | [X]Anankastic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60511 | Read | [X]Compulsive personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60512 | Read | [X]Obsessional personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60513 | Read | [X]Obsessive-compulsive personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60600 | Read | [X]Anxious [avoidant] personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60700 | Read | [X]Dependent personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60711 | Read | [X]Asthenic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60712 | Read | [X]Inadequate personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60713 | Read | [X]Passive personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60714 | Read | [X]Self defeating personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60y00 | Read | [X]Other specific personality disorders | diagnostic | res38: Personality disorder | |||
| Eu60y11 | Read | [X]Eccentric personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60y12 | Read | [X]Haltlose type personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60y13 | Read | [X]Immature personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60y14 | Read | [X]Narcissistic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60y16 | Read | [X]Psychoneurotic personality disorder | diagnostic | res38: Personality disorder | |||
| Eu60z00 | Read | [X]Personality disorder, unspecified | diagnostic | res38: Personality disorder | |||
| Eu61.00 | Read | [X]Mixed and other personality disorders | diagnostic | res38: Personality disorder | |||
| Eu84511 | Read | [X]Autistic psychopathy | diagnostic | res38: Personality disorder | |||
| Eu94211 | Read | [X]Affectionless psychopathy | diagnostic | res38: Personality disorder |
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