Code list: res59: Conduct

Research article:

Incidence, clinical management, and mortality risk following self-harm among children and adolescents: cohort study in primary care

Reference:

C Morgan, RT Webb, MJ Carr, E Kontopantelis, J Green, CA Chew-Graham, N Kapur, DM Ashcroft (2017) Incidence, clinical management, and mortality risk following self-harm among children and adolescents: cohort study in primary care. The BMJ, doi: doi.org/10.1136/bmj.j4351

Link to fulltext article
Abstract: Abstract Objectives To examine temporal trends in sex and age specific incidence of self harm in children and adolescents, clinical management patterns, and risk of cause specific mortality following an index self harm episode at a young age. Design Population based cohort study. Setting UK Clinical Practice Research Datalink—electronic health records from 674 general practices, with practice level deprivation measured ecologically using the index of multiple deprivation. Patients from eligible English practices were linked to hospital episode statistics (HES) and Office for National Statistics (ONS) mortality records. Participants For the descriptive analytical phases we examined data pertaining to 16 912 patients aged 10-19 who harmed themselves during 2001-14. For analysis of cause specific mortality following self harm, 8638 patients eligible for HES and ONS linkage were matched by age, sex, and general practice with up to 20 unaffected children and adolescents (n=170 274). Main outcome measures In the first phase, temporal trends in sex and age specific annual incidence were examined. In the second phase, clinical management was assessed according to the likelihood of referral to mental health services and psychotropic drug prescribing. In the third phase, relative risks of all cause mortality, unnatural death (including suicide and accidental death), and fatal acute alcohol or drug poisoning were estimated as hazard ratios derived from stratified Cox proportional hazards models for the self harm cohort versus the matched unaffected comparison cohort. Results The annual incidence of self harm was observed to increase in girls (37.4 per 10 000) compared with boys (12.3 per 10 000), and a sharp 68% increase occurred among girls aged 13-16, from 45.9 per 10 000 in 2011 to 77.0 per 10 000 in 2014. Referrals within 12 months of the index self harm episode were 23% less likely for young patients registered at the most socially deprived practices, even though incidences were considerably higher in these localities. Children and adolescents who harmed themselves were approximately nine times more likely to die unnaturally during follow-up, with especially noticeable increases in risks of suicide (deprivation adjusted hazard ratio 17.5, 95% confidence interval 7.6 to 40.5) and fatal acute alcohol or drug poisoning (34.3, 10.2 to 115.7). Conclusions Gaining a better understanding of the mechanisms responsible for the recent apparent increase in the incidence of self harm among early-mid teenage girls, and coordinated initiatives to tackle health inequalities in the provision of services to distressed children and adolescents, represent urgent priorities for multiple public agencies.
Author for correspondence: Catharine Morgan
Email for correspondence: cathy.morgan@manchester.ac.uk

Code list: res59: Conduct_disorder

34 codes in list

Code	Coding system	Description	Entity type	List name
E284.00	Read	stress reaction causing mixed disturbance of emotion/conduct	diagnostic	res59: Conduct_disorder
E2C..00	Read	disturbance of conduct nec	diagnostic	res59: Conduct_disorder
E2C0.00	Read	aggressive unsocial conduct disorder	diagnostic	res59: Conduct_disorder
E2C0z00	Read	aggressive unsocial conduct disorder nos	diagnostic	res59: Conduct_disorder
E2C1.00	Read	nonaggressive unsocial conduct disorder	diagnostic	res59: Conduct_disorder
E2C1z00	Read	nonaggressive unsocial conduct disorder nos	diagnostic	res59: Conduct_disorder
E2C2.00	Read	socialised conduct disorder	diagnostic	res59: Conduct_disorder
E2C2z00	Read	socialised conduct disorder nos	diagnostic	res59: Conduct_disorder
E2C4.00	Read	mixed disturbance of conduct and emotion	diagnostic	res59: Conduct_disorder
E2C4z00	Read	mixed disturbance of conduct and emotion nos	diagnostic	res59: Conduct_disorder
E2Cy.00	Read	other conduct disturbances	diagnostic	res59: Conduct_disorder
E2Cyz00	Read	other conduct disturbances nos	diagnostic	res59: Conduct_disorder
E2Cz.00	Read	unspecified disturbance of conduct	diagnostic	res59: Conduct_disorder
E2Czz00	Read	disturbance of conduct nos	diagnostic	res59: Conduct_disorder
E2Dy000	Read	childhood and adolescent oppositional disorder	diagnostic	res59: Conduct_disorder
E2E2.00	Read	Hyperkinetic conduct disorder	diagnostic	res59: Conduct_disorder
Eu90100	Read	[X]Hyperkinetic conduct disorder	diagnostic	res59: Conduct_disorder
Eu90111	Read	[X]Hyperkinetic disorder associated with conduct disorder	diagnostic	res59: Conduct_disorder
Eu91.00	Read	[x]conduct disorders	diagnostic	res59: Conduct_disorder
Eu91000	Read	[x]conduct disorder confined to the family context	diagnostic	res59: Conduct_disorder
Eu91100	Read	[x]unsocialized conduct disorder	diagnostic	res59: Conduct_disorder
Eu91111	Read	[x]conduct disorder, solitary aggressive type	diagnostic	res59: Conduct_disorder
Eu91200	Read	[x]socialized conduct disorder	diagnostic	res59: Conduct_disorder
Eu91300	Read	[X]Oppositional defiant disorder	diagnostic	res59: Conduct_disorder
Eu91y00	Read	[x]other conduct disorders	diagnostic	res59: Conduct_disorder
Eu91z00	Read	[x]conduct disorder, unspecified	diagnostic	res59: Conduct_disorder
Eu91z11	Read	[X]Childhood behavioural disorder NOS	diagnostic	res59: Conduct_disorder
Eu91z12	Read	[x]childhood conduct disorder nos	diagnostic	res59: Conduct_disorder
Eu92.00	Read	[x]mixed disorders of conduct and emotions	diagnostic	res59: Conduct_disorder
Eu92000	Read	[x]depressive conduct disorder	diagnostic	res59: Conduct_disorder
Eu92y00	Read	[x]other mixed disorders of conduct and emotions	diagnostic	res59: Conduct_disorder
Eu92y11	Read	[x]conduct disorder associated with emotional disorder	diagnostic	res59: Conduct_disorder
Eu92y12	Read	[x]conduct disorder associated with neurotic disorder	diagnostic	res59: Conduct_disorder
Eu92z00	Read	[x]mixed disorder of conduct and emotions, unspecified	diagnostic	res59: Conduct_disorder

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