Code list: res59: Eating

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: Eating_disorder

41 codes in list

Code	Coding system	Description	Entity type	List name
1612.00	Read	Appetite loss - anorexia	diagnostic	res59: Eating_disorder
1612.11	Read	Anorexia symptom	diagnostic	res59: Eating_disorder
1614.00	Read	Excessive eating - polyphagia	diagnostic	res59: Eating_disorder
1614.11	Read	Hyperalimentation - symptom	diagnostic	res59: Eating_disorder
1614.12	Read	Polyphagia symptom	diagnostic	res59: Eating_disorder
8HTN.00	Read	Referral to eating disorders clinic	diagnostic	res59: Eating_disorder
9Nk9.00	Read	Seen in eating disorder clinic	diagnostic	res59: Eating_disorder
E271.00	Read	Anorexia nervosa	diagnostic	res59: Eating_disorder
E275.00	Read	Other and unspecified non-organic eating disorders	diagnostic	res59: Eating_disorder
E275000	Read	Unspecified non-organic eating disorder	diagnostic	res59: Eating_disorder
E275100	Read	Bulimia (non-organic overeating)	diagnostic	res59: Eating_disorder
E275111	Read	Compulsive eating disorder	diagnostic	res59: Eating_disorder
E275300	Read	Psychogenic rumination	diagnostic	res59: Eating_disorder
E275400	Read	Psychogenic vomiting NOS	diagnostic	res59: Eating_disorder
E275y00	Read	Other specified non-organic eating disorder	diagnostic	res59: Eating_disorder
E275z00	Read	Non-organic eating disorder NOS	diagnostic	res59: Eating_disorder
Eu50.00	Read	[X]Eating disorders	diagnostic	res59: Eating_disorder
Eu50000	Read	[X]Anorexia nervosa	diagnostic	res59: Eating_disorder
Eu50100	Read	[X]Atypical anorexia nervosa	diagnostic	res59: Eating_disorder
Eu50200	Read	[X]Bulimia nervosa	diagnostic	res59: Eating_disorder
Eu50211	Read	[X]Bulimia NOS	diagnostic	res59: Eating_disorder
Eu50212	Read	[X]Hyperorexia nervosa	diagnostic	res59: Eating_disorder
Eu50300	Read	[X]Atypical bulimia nervosa	diagnostic	res59: Eating_disorder
Eu50400	Read	[X]Overeating associated with other psychological disturbncs	diagnostic	res59: Eating_disorder
Eu50411	Read	[X]Psychogenic overeating	diagnostic	res59: Eating_disorder
Eu50500	Read	[X]Vomiting associated with other psychological disturbances	diagnostic	res59: Eating_disorder
Eu50511	Read	[X]Psychogenic vomiting	diagnostic	res59: Eating_disorder
Eu50y00	Read	[X]Other eating disorders	diagnostic	res59: Eating_disorder
Eu50z00	Read	[X]Eating disorder; unspecified	diagnostic	res59: Eating_disorder
Fy05.00	Read	Nocturnal sleep-related eating disorder	diagnostic	res59: Eating_disorder
R030.00	Read	[D]Anorexia	diagnostic	res59: Eating_disorder
R030z00	Read	[D]Anorexia NOS	diagnostic	res59: Eating_disorder
R036.00	Read	[D]Polyphagia	diagnostic	res59: Eating_disorder
R036000	Read	[D]Excessive eating	diagnostic	res59: Eating_disorder
R036011	Read	[D]Bulimia NOS	diagnostic	res59: Eating_disorder
R036100	Read	[D]Hyperalimentation	diagnostic	res59: Eating_disorder
R036z00	Read	[D]Polyphagia NOS	diagnostic	res59: Eating_disorder
SN42100	Read	Starvation	diagnostic	res59: Eating_disorder
U1B3.11	Read	[X]Starvation	diagnostic	res59: Eating_disorder
Z4B5.00	Read	Eating disorder counselling	diagnostic	res59: Eating_disorder
ZC2CD00	Read	Dietary advice for eating disorder	diagnostic	res59: Eating_disorder

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