[ { "phenotype_id": "PH377", "phenotype_version_id": 754, "name": "Eating Disorder", "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": "2021-10-06T16:16:25.782348Z", "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": "2021-10-06T16:16:25.782374Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "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": "Read codes v2", "value": 5 } ], "event_date_range": "01/01/2001 - 31/12/2013", "concept_information": [ { "concept_id": 1707, "concept_version_id": 4552, "concept_name": "Eating Disorder - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH377", "phenotype_version_id": 754, "phenotype_name": "Eating Disorder", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "1612.00", "description": "Appetite loss - anorexia", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1612.11", "description": "Anorexia symptom", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1614.00", "description": "Excessive eating - polyphagia", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1614.11", "description": "Hyperalimentation - symptom", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1614.12", "description": "Polyphagia symptom", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8HTN.00", "description": "Referral to eating disorders clinic", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "9Nk9.00", "description": "Seen in eating disorder clinic", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E271.00", "description": "Anorexia nervosa", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275.00", "description": "Other and unspecified non-organic eating disorders", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275000", "description": "Unspecified non-organic eating disorder", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275100", "description": "Bulimia (non-organic overeating)", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275111", "description": "Compulsive eating disorder", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275y00", "description": "Other specified non-organic eating disorder", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275z00", "description": "Non-organic eating disorder NOS", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50.00", "description": "[X]Eating disorders", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50000", "description": "[X]Anorexia nervosa", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50100", "description": "[X]Atypical anorexia nervosa", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50200", "description": "[X]Bulimia nervosa", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50211", "description": "[X]Bulimia NOS", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50212", "description": "[X]Hyperorexia nervosa", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50300", "description": "[X]Atypical bulimia nervosa", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50400", "description": "[X]Overeating associated with other psychological disturbncs", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50411", "description": "[X]Psychogenic overeating", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50y00", "description": "[X]Other eating disorders", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50y11", "description": "[X]Pica in adults", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50z00", "description": "[X]Eating disorder, unspecified", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Fy05.00", "description": "Nocturnal sleep-related eating disorder", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R030.00", "description": "[D]Anorexia", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R030z00", "description": "[D]Anorexia NOS", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036.00", "description": "[D]Polyphagia", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036000", "description": "[D]Excessive eating", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036011", "description": "[D]Bulimia NOS", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036100", "description": "[D]Hyperalimentation", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036z00", "description": "[D]Polyphagia NOS", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "SN42100", "description": "Starvation", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "U1B3.11", "description": "[X]Starvation", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Z4B5.00", "description": "Eating disorder counselling", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "ZC2CD00", "description": "Dietary advice for eating disorder", "attributes": { "Entity type": "res41: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/xyb2-m410", "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": 754, "version_name": "Eating Disorder", "version_date": "2021-10-06T16:16:25.803921Z", "is_published": true, "is_latest": true } ] } ]