ClinicalCodes.org

An online clinical codes repository to improve validity and reproducibility of medical database research

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: Depression

107 codes in list

Code Coding system Description Entity type List name
1B17.00 Read depressed diagnostic res59: Depression
2257.00 Read o/e - depressed diagnostic res59: Depression
62T1.00 Read puerperal depression diagnostic res59: Depression
9kQ..00 Read on full dose long term treatment depression - enh serv admin diagnostic res59: Depression
E001300 Read presenile dementia with depression diagnostic res59: Depression
E002100 Read Senile dementia with depression diagnostic res59: Depression
E004300 Read Arteriosclerotic dementia with depression diagnostic res59: Depression
E11..12 Read depressive psychoses diagnostic res59: Depression
E112.00 Read single major depressive episode diagnostic res59: Depression
E112000 Read single major depressive episode, unspecified diagnostic res59: Depression
E112100 Read single major depressive episode, mild diagnostic res59: Depression
E112.11 Read agitated depression diagnostic res59: Depression
E112.12 Read endogenous depression first episode diagnostic res59: Depression
E112.13 Read endogenous depression first episode diagnostic res59: Depression
E112.14 Read endogenous depression diagnostic res59: Depression
E112200 Read single major depressive episode, moderate diagnostic res59: Depression
E112300 Read single major depressive episode, severe, without psychosis diagnostic res59: Depression
E112400 Read single major depressive episode, severe, with psychosis diagnostic res59: Depression
E112z00 Read single major depressive episode nos diagnostic res59: Depression
E113.00 Read recurrent major depressive episode diagnostic res59: Depression
E113000 Read recurrent major depressive episodes, unspecified diagnostic res59: Depression
E113100 Read recurrent major depressive episodes, mild diagnostic res59: Depression
E113.11 Read endogenous depression - recurrent diagnostic res59: Depression
E113200 Read recurrent major depressive episodes, moderate diagnostic res59: Depression
E113300 Read recurrent major depressive episodes, severe, no psychosis diagnostic res59: Depression
E113400 Read recurrent major depressive episodes, severe, with psychosis diagnostic res59: Depression
E113700 Read recurrent depression diagnostic res59: Depression
E113z00 Read recurrent major depressive episode nos diagnostic res59: Depression
E118.00 Read Seasonal affective disorder diagnostic res59: Depression
E11y200 Read atypical depressive disorder diagnostic res59: Depression
E11z200 Read masked depression diagnostic res59: Depression
E130.00 Read reactive depressive psychosis diagnostic res59: Depression
E130.11 Read psychotic reactive depression diagnostic res59: Depression
E135.00 Read agitated depression diagnostic res59: Depression
E200300 Read anxiety with depression diagnostic res59: Depression
E204.00 Read neurotic depression reactive type diagnostic res59: Depression
E204.11 Read Postnatal depression diagnostic res59: Depression
E290.00 Read brief depressive reaction diagnostic res59: Depression
E290z00 Read brief depressive reaction nos diagnostic res59: Depression
E291.00 Read prolonged depressive reaction diagnostic res59: Depression
E2B..00 Read depressive disorder nec diagnostic res59: Depression
E2B0.00 Read postviral depression diagnostic res59: Depression
E2B1.00 Read chronic depression diagnostic res59: Depression
Eu20400 Read [x]post-schizophrenic depression diagnostic res59: Depression
Eu32.00 Read [x]depressive episode diagnostic res59: Depression
Eu32000 Read [x]mild depressive episode diagnostic res59: Depression
Eu32100 Read [x]moderate depressive episode diagnostic res59: Depression
Eu32.11 Read [x]single episode of depressive reaction diagnostic res59: Depression
Eu32.12 Read [x]single episode of psychogenic depression diagnostic res59: Depression
Eu32.13 Read [x]single episode of reactive depression diagnostic res59: Depression
Eu32200 Read [x]severe depressive episode without psychotic symptoms diagnostic res59: Depression
Eu32211 Read [X]Single episode agitated depressn w'out psychotic symptoms diagnostic res59: Depression
Eu32212 Read [x]single episode major depression w'out psychotic symptoms diagnostic res59: Depression
Eu32213 Read [x]single episode vital depression w'out psychotic symptoms diagnostic res59: Depression
Eu32300 Read [x]severe depressive episode with psychotic symptoms diagnostic res59: Depression
Eu32311 Read [x]single episode of major depression and psychotic symptoms diagnostic res59: Depression
Eu32312 Read [x]single episode of psychogenic depressive psychosis diagnostic res59: Depression
Eu32313 Read [x]single episode of psychotic depression diagnostic res59: Depression
Eu32314 Read [x]single episode of reactive depressive psychosis diagnostic res59: Depression
Eu32400 Read [x]mild depression diagnostic res59: Depression
Eu32500 Read [x]major depression, mild diagnostic res59: Depression
Eu32600 Read [x]major depression, moderately severe diagnostic res59: Depression
Eu32700 Read [x]major depression, severe without psychotic symptoms diagnostic res59: Depression
Eu32800 Read [x]major depression, severe with psychotic symptoms diagnostic res59: Depression
Eu32900 Read [X]Single major depr ep, severe with psych, psych in remiss diagnostic res59: Depression
Eu32A00 Read [X]Recurr major depr ep, severe with psych, psych in remiss diagnostic res59: Depression
Eu32y00 Read [x]other depressive episodes diagnostic res59: Depression
Eu32y11 Read [x]atypical depression diagnostic res59: Depression
Eu32y12 Read [x]single episode of masked depression nos diagnostic res59: Depression
Eu32z00 Read [x]depressive episode, unspecified diagnostic res59: Depression
Eu32z11 Read [x]depression nos diagnostic res59: Depression
Eu32z12 Read [x]depressive disorder nos diagnostic res59: Depression
Eu32z13 Read [x]prolonged single episode of reactive depression diagnostic res59: Depression
Eu32z14 Read [x] reactive depression nos diagnostic res59: Depression
Eu33.00 Read [x]recurrent depressive disorder diagnostic res59: Depression
Eu33000 Read [x]recurrent depressive disorder, current episode mild diagnostic res59: Depression
Eu33100 Read [x]recurrent depressive disorder, current episode moderate diagnostic res59: Depression
Eu33.11 Read [x]recurrent episodes of depressive reaction diagnostic res59: Depression
Eu33.12 Read [x]recurrent episodes of psychogenic depression diagnostic res59: Depression
Eu33.13 Read [x]recurrent episodes of reactive depression diagnostic res59: Depression
Eu33.14 Read [x]seasonal depressive disorder diagnostic res59: Depression
Eu33.15 Read [X]SAD - Seasonal affective disorder diagnostic res59: Depression
Eu33200 Read [X]Recurr depress disorder cur epi severe without psyc sympt diagnostic res59: Depression
Eu33211 Read [x]endogenous depression without psychotic symptoms diagnostic res59: Depression
Eu33212 Read [x]major depression, recurrent without psychotic symptoms diagnostic res59: Depression
Eu33214 Read [x]vital depression, recurrent without psychotic symptoms diagnostic res59: Depression
Eu33300 Read [X]Recurrent depress disorder cur epi severe with psyc symp diagnostic res59: Depression
Eu33311 Read [x]endogenous depression with psychotic symptoms diagnostic res59: Depression
Eu33312 Read [x]manic-depress psychosis,depressed type+psychotic symptoms diagnostic res59: Depression
Eu33313 Read [x]recurr severe episodes/major depression+psychotic symptom diagnostic res59: Depression
Eu33314 Read [x]recurr severe episodes/psychogenic depressive psychosis diagnostic res59: Depression
Eu33315 Read [x]recurrent severe episodes of psychotic depression diagnostic res59: Depression
Eu33316 Read [x]recurrent severe episodes/reactive depressive psychosis diagnostic res59: Depression
Eu33400 Read [x]recurrent depressive disorder, currently in remission diagnostic res59: Depression
Eu33y00 Read [x]other recurrent depressive disorders diagnostic res59: Depression
Eu33z00 Read [x]recurrent depressive disorder, unspecified diagnostic res59: Depression
Eu33z11 Read [x]monopolar depression nos diagnostic res59: Depression
Eu34100 Read [x]dysthymia diagnostic res59: Depression
Eu34111 Read [x]depressive neurosis diagnostic res59: Depression
Eu34113 Read [x]neurotic depression diagnostic res59: Depression
Eu34114 Read [x]persistant anxiety depression diagnostic res59: Depression
Eu3y111 Read [x]recurrent brief depressive episodes diagnostic res59: Depression
Eu41200 Read [x]mixed anxiety and depressive disorder diagnostic res59: Depression
Eu41211 Read [x]mild anxiety depression diagnostic res59: Depression
Eu53011 Read [X]Postnatal depression NOS diagnostic res59: Depression
Eu53012 Read [X]Postpartum depression NOS diagnostic res59: Depression
Eu92000 Read [x]depressive conduct disorder diagnostic res59: Depression

0 comments have been posted.

Please log in to leave a comment.

Quick links:

Code list links:

Only the original uploading author or an administrator can add, edit or delete this article and its associated codes.

University of Manchester IPH ClinicalCodes is a project at the University of Manchester Institute of Population Health

Funded by NIHR School for Primary Care The ClinicalCodes project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR)

© 2013-2014 University of Manchester all rights reserved