ClinicalCodes.org
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Research article:
Short- and long-term risk of premature death in a nationally representative cohort of primary care patients with history of self-harm
Reference:
Matthew J. Carr, Darren M. Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T. Webb (2016) Short- and long-term risk of premature death in a nationally representative cohort of primary care patients with history of self-harm. BMJ, doi:
- Link to article
- Abstract
- Objectives: To examine premature mortality in a nationally representative cohort of primary care patients who have harmed themselves, and to estimate relative risks versus the general population stratified by follow-up time from first to tenth year. Design: Matched cohort study. Setting: 385 general practices in England contributing data to the Clinical Practice Research Datalink (CPRD) during 2001-2013 with linkage to national mortality records. Population: Index cohort of 30,017 persons aged 15-64 years with a record of self-harm; comparison cohort, sampled from the same population, consisting of 600,258 persons with no record of self-harm and matched to index patients on age (year of birth), gender and registered general practice. Main outcome measures: Hazards ratios for all-cause and cause-specific mortality, including unnatural vs. natural death, suicide, intentional vs. accidental poisoning, and alcohol-related death. Results: We found greatly raised risk of dying prematurely from any cause among members of the self-harm cohort, especially so during the first follow-up year: hazard ratio (HR) 9.9, 95% confidence interval (CI) 8.6 to 11.4. The elevation in suicide risk within a year was especially great (HR 113.9, CI 73.9 to 175.6). Beyond the first follow-up year, suicide risk declined sharply but remained much higher than in the comparison cohort. Large risk elevations throughout the follow-up period were observed for accidental self-poisoning and alcohol-related death. Conclusions: Primary care patients who have harmed themselves are at greatly increased risk of dying prematurely by suicide and by other causes, and especially so within a year of the index episode. Relatively frequent general practice attendance by these individuals presents a clear opportunity for preventive action in primary care. National clinical guidelines could provide more specific recommendations for how primary healthcare teams can monitor, intervene and manage risk in these patients more effectively.
- Author for correspondence
- Matthew J Carr
- Email for correspondence
- matthew.carr@manchester.ac.uk
Code list: res41: SSRI ADDs
120 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 03837020 | Multilex | Prozac 20mg capsules (Lexon (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 03985020 | Multilex | Citalopram 20mg tablets (Alliance Healthcare (Distribution) Ltd) | drug | res41: SSRI ADDs | |||
| 03997020 | Multilex | Citalopram 20mg tablets (Bristol Laboratories Ltd) | drug | res41: SSRI ADDs | |||
| 04003020 | Multilex | Citalopram 10mg tablets (Kent Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 04004020 | Multilex | Citalopram 10mg tablets (Alliance Healthcare (Distribution) Ltd) | drug | res41: SSRI ADDs | |||
| 04007020 | Multilex | Citalopram 10mg tablets (Arrow Generics Ltd) | drug | res41: SSRI ADDs | |||
| 04011020 | Multilex | Citalopram 10mg tablets (Bristol Laboratories Ltd) | drug | res41: SSRI ADDs | |||
| 20738020 | Multilex | Sertraline 100mg/5ml oral suspension | drug | res41: SSRI ADDs | |||
| 33816020 | Multilex | Sertraline 25mg/5ml oral suspension | drug | res41: SSRI ADDs | |||
| 38526020 | Multilex | Citalopram 20mg tablets (DE Pharmaceuticals) | drug | res41: SSRI ADDs | |||
| 49680020 | Multilex | Felicium 20mg capsules (Opus Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 53823020 | Multilex | Escitalopram 20mg tablets | drug | res41: SSRI ADDs | |||
| 55602020 | Multilex | Cipralex 20mg tablets (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 60735020 | Multilex | Fluvoxamine 100mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res41: SSRI ADDs | |||
| 61084020 | Multilex | Fluoxetine 20mg capsules (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 61167020 | Multilex | Fluoxetine 20mg capsules (IVAX Pharmaceuticals UK Ltd) | drug | res41: SSRI ADDs | |||
| 61319020 | Multilex | Fluoxetine 20mg capsules (Teva UK Ltd) | drug | res41: SSRI ADDs | |||
| 61387020 | Multilex | Fluoxetine 20mg capsules (Sandoz Ltd) | drug | res41: SSRI ADDs | |||
| 61409020 | Multilex | Fluoxetine 20mg capsules (Generics (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 61420020 | Multilex | Fluoxetine 20mg capsules (Niche Generics Ltd) | drug | res41: SSRI ADDs | |||
| 61439020 | Multilex | Fluoxetine 20mg capsules (Wockhardt UK Ltd) | drug | res41: SSRI ADDs | |||
| 61452020 | Multilex | Fluoxetine 20mg capsules (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 61455020 | Multilex | Fluoxetine 20mg capsules (Genus Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 61616020 | Multilex | Fluoxetine 20mg capsules (Zentiva) | drug | res41: SSRI ADDs | |||
| 62069020 | Multilex | Fluvoxamine 50mg tablets | drug | res41: SSRI ADDs | |||
| 62070020 | Multilex | Fluvoxamine 100mg tablets | drug | res41: SSRI ADDs | |||
| 62073020 | Multilex | Faverin 50mg tablets (Abbott Healthcare Products Ltd) | drug | res41: SSRI ADDs | |||
| 62074020 | Multilex | Faverin 100mg tablets (Abbott Healthcare Products Ltd) | drug | res41: SSRI ADDs | |||
| 62693020 | Multilex | Fluvoxamine 100mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 62975020 | Multilex | Fluoxetine 20mg capsules (Fannin UK Ltd) | drug | res41: SSRI ADDs | |||
| 63016020 | Multilex | Fluoxetine 20mg capsules (Ranbaxy (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 63703020 | Multilex | Paroxetine 20mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res41: SSRI ADDs | |||
| 64692020 | Multilex | Fluoxetine 20mg/5ml oral solution (Teva UK Ltd) | drug | res41: SSRI ADDs | |||
| 64717020 | Multilex | Fluoxetine 20mg/5ml oral solution (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 65125020 | Multilex | Citalopram 10mg tablets (Sandoz Ltd) | drug | res41: SSRI ADDs | |||
| 65128020 | Multilex | Citalopram 20mg tablets (Sandoz Ltd) | drug | res41: SSRI ADDs | |||
| 65131020 | Multilex | Citalopram 40mg tablets (Sandoz Ltd) | drug | res41: SSRI ADDs | |||
| 65254020 | Multilex | Citalopram 10mg Tablet (Neo Laboratories Ltd) | drug | res41: SSRI ADDs | |||
| 65257020 | Multilex | Citalopram 20mg Tablet (Neo Laboratories Ltd) | drug | res41: SSRI ADDs | |||
| 65262020 | Multilex | Citalopram 40mg Tablet (Neo Laboratories Ltd) | drug | res41: SSRI ADDs | |||
| 65376020 | Multilex | Citalopram 10mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 65381020 | Multilex | Citalopram 20mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 65386020 | Multilex | Citalopram 40mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 65464020 | Multilex | Fluoxetine 60mg capsules (Generics (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 65578020 | Multilex | Paroxetine 20mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 66129020 | Multilex | Fluoxetine 20mg/5ml oral solution (IVAX Pharmaceuticals UK Ltd) | drug | res41: SSRI ADDs | |||
| 66149020 | Multilex | Citalopram 10mg tablets (Zentiva) | drug | res41: SSRI ADDs | |||
| 66152020 | Multilex | Citalopram 20mg tablets (Zentiva) | drug | res41: SSRI ADDs | |||
| 66160020 | Multilex | Citalopram 40mg tablets (Zentiva) | drug | res41: SSRI ADDs | |||
| 66244020 | Multilex | Fluvoxamine 100mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 66273020 | Multilex | Fluoxetine 20mg capsules (Tillomed Laboratories Ltd) | drug | res41: SSRI ADDs | |||
| 66399020 | Multilex | Paroxetine 20mg tablets (Generics (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 66451020 | Multilex | Citalopram 10mg tablets (Generics (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 66454020 | Multilex | Citalopram 20mg tablets (Generics (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 66459020 | Multilex | Citalopram 40mg tablets (Generics (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 66464020 | Multilex | Paroxetine 20mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 66680020 | Multilex | Citalopram 10mg tablets (Niche Generics Ltd) | drug | res41: SSRI ADDs | |||
| 66685020 | Multilex | Citalopram 20mg tablets (Niche Generics Ltd) | drug | res41: SSRI ADDs | |||
| 66688020 | Multilex | Citalopram 40mg tablets (Niche Generics Ltd) | drug | res41: SSRI ADDs | |||
| 67575020 | Multilex | Paroxetine 30mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 67650020 | Multilex | Paroxetine 30mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 67890020 | Multilex | Citalopram 10mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 67893020 | Multilex | Citalopram 20mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 67898020 | Multilex | Citalopram 40mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 68042020 | Multilex | Citalopram 10mg tablets (Teva UK Ltd) | drug | res41: SSRI ADDs | |||
| 68045020 | Multilex | Citalopram 20mg tablets (Teva UK Ltd) | drug | res41: SSRI ADDs | |||
| 68049020 | Multilex | Citalopram 40mg tablets (Teva UK Ltd) | drug | res41: SSRI ADDs | |||
| 69506020 | Multilex | Prozac 20mg capsules (Eli Lilly and Company Ltd) | drug | res41: SSRI ADDs | |||
| 69507020 | Multilex | Prozac 20mg/5ml liquid (Eli Lilly and Company Ltd) | drug | res41: SSRI ADDs | |||
| 69508020 | Multilex | Prozac 60mg capsules (Eli Lilly and Company Ltd) | drug | res41: SSRI ADDs | |||
| 69654020 | Multilex | Fluoxetine 20mg capsules | drug | res41: SSRI ADDs | |||
| 69655020 | Multilex | Fluoxetine 20mg/5ml oral solution | drug | res41: SSRI ADDs | |||
| 69656020 | Multilex | Fluoxetine 60mg capsules | drug | res41: SSRI ADDs | |||
| 69754020 | Multilex | Paroxetine 20mg tablets (Genus Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 71214020 | Multilex | Citalopram 10mg tablets (PLIVA Pharma Ltd) | drug | res41: SSRI ADDs | |||
| 71225020 | Multilex | Citalopram 10mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res41: SSRI ADDs | |||
| 71373020 | Multilex | Citalopram 10mg tablets (Almus Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 71376020 | Multilex | Citalopram 20mg tablets (Almus Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 71725020 | Multilex | Sertraline 50mg tablets (A A H Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 72034020 | Multilex | Sertraline 50mg tablets (Actavis UK Ltd) | drug | res41: SSRI ADDs | |||
| 72095020 | Multilex | Sertraline 100mg tablets (Teva UK Ltd) | drug | res41: SSRI ADDs | |||
| 72932020 | Multilex | Paroxetine 20mg tablets | drug | res41: SSRI ADDs | |||
| 72933020 | Multilex | Paroxetine 30mg tablets | drug | res41: SSRI ADDs | |||
| 72934020 | Multilex | Paroxetine 10mg/5ml oral suspension sugar free | drug | res41: SSRI ADDs | |||
| 72937020 | Multilex | Seroxat 20mg tablets (GlaxoSmithKline UK Ltd) | drug | res41: SSRI ADDs | |||
| 72938020 | Multilex | Seroxat 30mg tablets (GlaxoSmithKline UK Ltd) | drug | res41: SSRI ADDs | |||
| 72939020 | Multilex | Seroxat 20mg/10ml liquid (GlaxoSmithKline UK Ltd) | drug | res41: SSRI ADDs | |||
| 74046020 | Multilex | Lustral 50mg tablets (Pfizer Ltd) | drug | res41: SSRI ADDs | |||
| 74047020 | Multilex | Lustral 100mg tablets (Pfizer Ltd) | drug | res41: SSRI ADDs | |||
| 74050020 | Multilex | Sertraline 50mg tablets | drug | res41: SSRI ADDs | |||
| 74051020 | Multilex | Sertraline 100mg tablets | drug | res41: SSRI ADDs | |||
| 74425020 | Multilex | Fluoxetine 20mg Capsule (Milpharm Ltd) | drug | res41: SSRI ADDs | |||
| 75620020 | Multilex | Sertraline 50mg tablets (Almus Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 77306020 | Multilex | Citalopram 40mg/ml oral drops sugar free | drug | res41: SSRI ADDs | |||
| 77312020 | Multilex | Cipramil 40mg/ml drops (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 78768020 | Multilex | Escitalopram 10mg tablets | drug | res41: SSRI ADDs | |||
| 79420020 | Multilex | Cipramil 20mg tablets (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 79421020 | Multilex | Cipramil 10mg tablets (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 79422020 | Multilex | Cipramil 40mg tablets (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 79462020 | Multilex | Citalopram 20mg tablets | drug | res41: SSRI ADDs | |||
| 79463020 | Multilex | Citalopram 10mg tablets | drug | res41: SSRI ADDs | |||
| 79464020 | Multilex | Citalopram 40mg tablets | drug | res41: SSRI ADDs | |||
| 80679020 | Multilex | Oxactin 20mg capsules (Discovery Pharmaceuticals Ltd) | drug | res41: SSRI ADDs | |||
| 80777020 | Multilex | Prozit 20mg/5ml oral solution (Pinewood Healthcare) | drug | res41: SSRI ADDs | |||
| 82055020 | Multilex | Ranflutin 20mg capsules (Ranbaxy (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 86222020 | Multilex | Cipralex 10mg tablets (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 87524020 | Multilex | Escitalopram 5mg tablets | drug | res41: SSRI ADDs | |||
| 87526020 | Multilex | Cipralex 5mg tablets (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 88346020 | Multilex | Paxoran 10mg Tablet (Ranbaxy (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 88348020 | Multilex | Paxoran 20mg Tablet (Ranbaxy (UK) Ltd) | drug | res41: SSRI ADDs | |||
| 90497020 | Multilex | Sertraline 50mg/5ml oral suspension | drug | res41: SSRI ADDs | |||
| 90871020 | Multilex | Escitalopram 10mg/ml oral drops sugar free | drug | res41: SSRI ADDs | |||
| 90873020 | Multilex | Cipralex 10mg/ml oral drops (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 92043020 | Multilex | Paroxetine 10mg tablets | drug | res41: SSRI ADDs | |||
| 93187020 | Multilex | Seroxat 10mg tablets (GlaxoSmithKline UK Ltd) | drug | res41: SSRI ADDs | |||
| 93918020 | Multilex | Prozep 20mg/5ml oral solution (Chemidex Pharma Ltd) | drug | res41: SSRI ADDs | |||
| 93984020 | Multilex | Fluoxetine 20mg/5ml oral solution sugar free | drug | res41: SSRI ADDs | |||
| 97169020 | Multilex | Escitalopram 20mg/ml oral drops sugar free | drug | res41: SSRI ADDs | |||
| 97171020 | Multilex | Cipralex 20mg/ml oral drops (Lundbeck Ltd) | drug | res41: SSRI ADDs | |||
| 98001020 | Multilex | Fluoxetine 10mg tablets | drug | res41: SSRI ADDs |
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