[ { "phenotype_id": "PH362", "phenotype_version_id": 724, "name": "Anxiolitics", "definition": "PURPOSE:\n\nSelf-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves.\n\n\nMETHODS:\n\nDuring 2001-2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm. We estimated the relative risks of all-cause and cause-specific natural and unnatural mortality using a comparison cohort of 600,258 individuals matched on age, sex, and general practice.\n\n\nRESULTS:\n\nWe found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio for that year, 3.6; 95% CI, 3.1-4.2). In particular, suicide risk was especially high during the first year (adjusted hazard ratio, 54.4; 95% CI, 34.3-86.3); although it declined sharply, it remained much higher than that in the comparison cohort. Large elevations of risk throughout the follow-up period were also observed for accidental, alcohol-related, and drug poisoning deaths. At 10 years of follow-up, cumulative incidence values were 6.5% (95% CI, 6.0%-7.1%) for allcause mortality and 1.3% (95% CI, 1.2%-1.5%) for suicide.\n\n\nCONCLUSIONS:\n\nPrimary care patients who have harmed themselves are at greatly increased risk of dying prematurely by natural and unnatural causes, and especially within a year of a first episode. These individuals visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. Primary care patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require concerted, multipronged, multidisciplinary collaborative care approaches.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb, Premature Death Among Primary Care Patients With a History of Self-Harm. Annals of Family Medicine, 15(3), 2017." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:15:45.244626Z", "author": "Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:15:45.244653Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Drug", "value": "3" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Multilex codes", "value": 16 } ], "event_date_range": "01/01/2001 - 31/12/2013", "concept_information": [ { "concept_id": 1691, "concept_version_id": 4520, "concept_name": "Anxiolitics - Primary Care", "coding_system": { "id": 16, "name": "Multilex codes", "description": "Multilex codes" }, "phenotype_id": "PH362", "phenotype_version_id": 724, "phenotype_name": "Anxiolitics", "code_attribute_header": [ "Entity type", "Coding System (Multilex)", "Category" ], "codes": [ { "code": "39801020", "description": "Zimovane 7.5mg tablets (Lexon (UK) Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "479021", "description": "Zopiclone 3.75mg/5ml oral solution", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59209020", "description": "Zopiclone 7.5mg tablets (Actavis UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59210020", "description": "Zopiclone 3.75mg tablets (Actavis UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59236020", "description": "Zopiclone 3.75mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59237020", "description": "Zopiclone 7.5mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59593020", "description": "Zopiclone 3.75mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59594020", "description": "Zopiclone 7.5mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59784020", "description": "Zopiclone 7.5mg tablets (Generics (UK) Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59785020", "description": "Zopiclone 3.75mg tablets (Generics (UK) Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "60509020", "description": "Zopiclone 3.75mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "60510020", "description": "Zopiclone 7.5mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "62715020", "description": "Zopiclone 7.5mg tablets (Sandoz Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63436020", "description": "Zopiclone 7.5mg tablets (Kent Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63765020", "description": "Zopiclone 7.5mg tablets (PLIVA Pharma Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63881020", "description": "Zolpidem 5mg Tablet (Winthrop Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63882020", "description": "Zolpidem 10mg Tablet (Winthrop Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64484020", "description": "Zolpidem 5mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64487020", "description": "Zolpidem 10mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64733020", "description": "Zolpidem 5mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64738020", "description": "Zolpidem 10mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65546020", "description": "Zopiclone 3.75mg tablets (Kent Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65832020", "description": "Zolpidem 5mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65835020", "description": "Zolpidem 10mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "66946020", "description": "Zolpidem 10mg tablets (Generics (UK) Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "72408020", "description": "Zimovane 7.5mg tablets (Sanofi)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "72416020", "description": "Zopiclone 7.5mg tablets", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "72417020", "description": "Zopiclone 3.75mg tablets", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75692020", "description": "Zolpidem 5mg tablets", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75693020", "description": "Zolpidem 10mg tablets", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75696020", "description": "Stilnoct 5mg tablets (Sanofi)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75697020", "description": "Stilnoct 10mg tablets (Sanofi)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "83069020", "description": "Zimovane LS 3.75mg tablets (Sanofi)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "85821020", "description": "Zileze 3.75 tablets (Opus Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "85822020", "description": "Zileze 7.5 tablets (Opus Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86240020", "description": "Zaleplon 5mg capsules", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86241020", "description": "Zaleplon 10mg capsules", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86243020", "description": "Sonata 5mg capsules (Meda Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86244020", "description": "Sonata 10mg capsules (Meda Pharmaceuticals Ltd)", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "91009020", "description": "Zopiclone 3.75mg/5ml oral suspension", "attributes": { "Entity type": "res41: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/nxe9-0649", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 724, "version_name": "Anxiolitics", "version_date": "2021-10-06T16:15:45.267401Z", "is_published": true, "is_latest": true } ] } ]