[ { "phenotype_id": "PH370", "phenotype_version_id": 740, "name": "Depot APDs", "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": "2021-10-06T16:16:04.211404Z", "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": "2021-10-06T16:16:04.211432Z", "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": 1699, "concept_version_id": 4536, "concept_name": "Depot APDs - Primary Care", "coding_system": { "id": 16, "name": "Multilex codes", "description": "Multilex codes" }, "phenotype_id": "PH370", "phenotype_version_id": 740, "phenotype_name": "Depot APDs", "code_attribute_header": [ "Entity type", "Coding System (Multilex)", "Category" ], "codes": [ { "code": "48900020", "description": "Depixol -conc 100mg/ml Injection (Lundbeck Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "50445020", "description": "Modecate 25mg/ml Injection (Sanofi-Synthelabo Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "53027020", "description": "Clopixol 200mg/ml Oily injection (Lundbeck Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "53030020", "description": "Depixol 20mg/ml Injection (Lundbeck Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "53031020", "description": "Depixol 40mg/2ml solution for injection ampoules (Lundbeck Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "53053020", "description": "Modecate concentrate 100mg/ml Injection (Sanofi-Synthelabo Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "53586020", "description": "Piportil 50mg/ml Depot injection (JHC Healthcare Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "57938020", "description": "Depixol Low Volume 200mg/1ml solution for injection ampoules (Lundbeck Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", 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"Fluphenazine decanoate 100mg/ml Injection", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "62954020", "description": "Fluphenazine decanoate 25mg/ml Injection (Antigen Pharmaceuticals)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63123020", "description": "Haloperidol decanoate 50mg/1ml solution for injection ampoules", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63124020", "description": "Haloperidol decanoate 100mg/1ml solution for injection ampoules", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65842020", "description": "Pipotiazine palmitate 50mg/ml depot injection", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", 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"code": "91596020", "description": "Clopixol 200mg/1ml solution for injection ampoules (Lundbeck Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "91981020", "description": "Pipotiazine 50mg/1ml solution for injection ampoules", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "91985020", "description": "Pipotiazine 100mg/2ml solution for injection ampoules", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "91987020", "description": "Piportil Depot 50mg/1ml solution for injection ampoules (Sanofi)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "91989020", "description": "Piportil Depot 100mg/2ml solution for injection ampoules (Sanofi)", "attributes": { "Entity type": 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"drug" } }, { "code": "99843020", "description": "Paliperidone 75mg/0.75ml suspension for injection pre-filled syringes", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "99845020", "description": "Paliperidone 100mg/1ml suspension for injection pre-filled syringes", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "99847020", "description": "Paliperidone 150mg/1.5ml suspension for injection pre-filled syringes", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "99849020", "description": "Xeplion 50mg/0.5ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "99851020", "description": "Xeplion 75mg/0.75ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "99853020", "description": "Xeplion 100mg/1ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "99855020", "description": "Xeplion 150mg/1.5ml suspension for injection pre-filled syringes (Janssen-Cilag Ltd)", "attributes": { "Entity type": "res41: Depot APDs", "Coding System (Multilex)": "Multilex", "Category": "drug" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/ed2y-bv73", "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": 740, "version_name": "Depot APDs", "version_date": "2021-10-06T16:16:04.233872Z", "is_published": true, "is_latest": true } ] } ]