[ { "phenotype_id": "PH384", "phenotype_version_id": 768, "name": "Personality Disorder", "definition": "Background: \n\nLittle is known about the clinical management of patients in primary care following self-harm.\n\n\nMethods: \n\nA descriptive cohort study using data from 684 UK general practices that contributed to the Clinical Practice Research Datalink (CPRD) during 2001-2013. We identified 49,970 patients with a self-harm episode, 41,500 of whom had one complete year of follow-up.\n\n\nResults: \n\nAmong those with complete follow-up, 26,065 (62.8%, 62.3-63.3) were prescribed psychotropic medication and 6318 (15.2%, 14.9-15.6) were referred to mental health services; 4105 (9.9%, CI 9.6-10.2) were medicated without an antecedent psychiatric diagnosis or referral, and 4,506 (10.9%, CI 10.6-11.2) had a diagnosis but were not subsequently medicated or referred. Patients registered at practices in the most deprived localities were 27.1% (CI 21.5-32.2) less likely to be referred than those in the least deprived. Despite a specifically flagged NICE 'Do not do' recommendation in 2011 against prescribing tricyclic antidepressants following self-harm because of their potentially lethal toxicity in overdose, 8.8% (CI 7.8-9.8) of individuals were issued a prescription in the subsequent year. The percentage prescribed Citalopram, an SSRI antidepressant with higher toxicity in overdose, fell sharply during 2012/2013 in the aftermath of a Medicines and Healthcare products Regulatory Agency (MHRA) safety alert issued in 2011.\n\n\nConclusions: \n\nA relatively small percentage of these vulnerable patients are referred to mental health services, and reduced likelihood of referral in more deprived localities reflects a marked health inequality. National clinical guidelines have not yet been effective in reducing rates of tricyclic antidepressant prescribing for this high-risk group.\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 Awenant, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb, Clinical management following self-harm in a UK-wide primary care cohort. Journal of Affective Disorders, 197(2016) 182-188, 2016." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:16:49.640336Z", "author": "Matthew J Carr, Darren M Ashscroft, Evangelos Kontopantelis, David While, Yvonne Awenant, 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": "2021-10-06T16:16:49.640363Z", "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 - 31/12/2012", "concept_information": [ { "concept_id": 1714, "concept_version_id": 4566, "concept_name": "Personality Disorder - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH384", "phenotype_version_id": 768, "phenotype_name": "Personality Disorder", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "E21..00", "description": "Personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E210.00", "description": "Paranoid personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211.00", "description": "Affective personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211000", "description": "Unspecified affective personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21..11", "description": "Neurotic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211100", "description": "Hypomanic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211200", "description": "Depressive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211300", "description": "Cyclothymic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211z00", "description": "Affective personality disorder NOS", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E212.00", "description": "Schizoid personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E212000", "description": "Unspecified schizoid personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E212z00", "description": "Schizoid personality disorder NOS", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E213.00", "description": "Explosive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214.00", "description": "Compulsive personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214000", "description": "Anankastic personality", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214.11", "description": "Anancastic personality", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214z00", "description": "Compulsive personality disorder NOS", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215.00", "description": "Histrionic personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215000", "description": "Unspecified histrionic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215.11", "description": "Hysterical personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215z00", "description": "Histrionic personality disorder NOS", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E216.00", "description": "Inadequate personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E217.00", "description": "Antisocial or sociopathic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y.00", "description": "Other personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y000", "description": "Narcissistic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y100", "description": "Avoidant personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y200", "description": "Borderline personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y300", "description": "Passive-aggressive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y400", "description": "Eccentric personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y500", "description": "Immature personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y600", "description": "Masochistic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y700", "description": "Psychoneurotic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21yz00", "description": "Other personality disorder NOS", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21z.00", "description": "Personality disorder NOS", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21z.11", "description": "Psychopathic personality", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu06000", "description": "[X]Organic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu06011", "description": "[X]Organic pseudopsychopathic personality", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu21.17", "description": "[X]Pseudopsychopathic schizophrenia", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu21.18", "description": "[X]Schizotypal personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu34011", "description": "[X]Affective personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu34112", "description": "[X]Depressive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60.00", "description": "[X]Specific personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60000", "description": "[X]Paranoid personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60013", "description": "[X]Querulant personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60014", "description": "[X]Sensitive paranoid personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60100", "description": "[X]Schizoid personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60200", "description": "[X]Dissocial personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60212", "description": "[X]Antisocial personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60213", "description": "[X]Asocial personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60214", "description": "[X]Psychopathic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60215", "description": "[X]Sociopathic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60300", "description": "[X]Emotionally unstable personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60311", "description": "[X]Aggressive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60312", "description": "[X]Borderline personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60313", "description": "[X]Explosive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60400", "description": "[X]Histrionic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60411", "description": "[X]Hysterical personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60412", "description": "[X]Psychoinfantile personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60500", "description": "[X]Anankastic personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60511", "description": "[X]Compulsive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60512", "description": "[X]Obsessional personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60513", "description": "[X]Obsessive-compulsive personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60600", "description": "[X]Anxious [avoidant] personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60700", "description": "[X]Dependent personality disorder", "attributes": { "Entity type": "res36: Personality disorder", "Category": 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"diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60z00", "description": "[X]Personality disorder, unspecified", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu61.00", "description": "[X]Mixed and other personality disorders", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu84511", "description": "[X]Autistic psychopathy", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu94211", "description": "[X]Affectionless psychopathy", "attributes": { "Entity type": "res36: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/bqqf-d321", "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": 768, "version_name": "Personality Disorder", "version_date": "2021-10-06T16:16:49.669042Z", "is_published": true, "is_latest": true } ] } ]