[ { "phenotype_id": "PH701", "phenotype_version_id": 1402, "name": "Eating Disorder", "definition": "Background:\n\nLittle is known about the precursors of suicide risk among primary-care patients. This study aimed to examine suicide risk in relation to patterns of clinical consultation, psychotropic drug prescribing, and psychiatric diagnoses.\n\n\nMethod: \n\nNested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged516 years who died by suicide during 2002–2011 (N = 2384) were matched on gender, age and practice with up to 20 living control patients (N = 46 899).\n\n\nResults: \n\nRisk was raised among non-consulting patients, and increased sharply with rising number of consultations in the preceding year [512 consultations v. 1: unadjusted odds ratio (OR) 6.0, 95% confidence interval (CI) 4.9–7.3]. Markedly elevated risk was also associated with the prescribing of multiple psychotropic medication types (55 types v. 0: OR 62.6, CI 44.3–88.4) and with having several psychiatric diagnoses (54 diagnoses v. 0: OR 31.1, CI 19.3–50.1). Risk was also raised among patients living in more socially deprived localities. The confounding effect of multiple psychotropic drug types largely accounted for the rising risk gradient observed with increasing consultation frequency.\n\n\nConclusions: \n\nA greater proportion of patients with several psychiatric diagnoses, those prescribed multiple psychotropic medication types, and those who consult at very high frequency might be considered for referral to mental health services by their general practitioners. Non-consulters are also at increased risk, which suggests that conventional models of primary care may not be effective in meeting the needs of all people in the community experiencing major psychosocial difficulties.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "K Windfuhr, D While, N Kapur, D M Ashcroft, E Kontopantelis, M J Carr, J Shaw, L Appleby, R T Webb, Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary-care patients. Psychological Medicine, 46, 3407-3417, 2016." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:30:43.413969Z", "author": "K Windfuhr, D While, N Kapur, D M Ashcroft, E Kontopantelis, M J Carr, J Shaw, L Applyby, R T Webb", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:30:43.413997Z", "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": "01/01/2002 - 31/12/2011", "concept_information": [ { "concept_id": 2121, "concept_version_id": 5380, "concept_name": "Eating Disorder - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH701", "phenotype_version_id": 1402, "phenotype_name": "Eating Disorder", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "1612.00", "description": "Appetite loss - anorexia", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1612.11", "description": "Anorexia symptom", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1614.00", "description": "Excessive eating - polyphagia", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1614.11", "description": "Hyperalimentation - symptom", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "1614.12", "description": "Polyphagia symptom", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "8HTN.00", "description": "Referral to eating disorders clinic", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "9Nk9.00", "description": "Seen in eating disorder clinic", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E271.00", "description": "Anorexia nervosa", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275.00", "description": "Other and unspecified non-organic eating disorders", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275000", "description": "Unspecified non-organic eating disorder", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275100", "description": "Bulimia (non-organic overeating)", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275111", "description": "Compulsive eating disorder", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275y00", "description": "Other specified non-organic eating disorder", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E275z00", "description": "Non-organic eating disorder NOS", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50.00", "description": "[X]Eating disorders", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50000", "description": "[X]Anorexia nervosa", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50100", "description": "[X]Atypical anorexia nervosa", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50200", "description": "[X]Bulimia nervosa", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50211", "description": "[X]Bulimia NOS", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50212", "description": "[X]Hyperorexia nervosa", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50300", "description": "[X]Atypical bulimia nervosa", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50400", "description": "[X]Overeating associated with other psychological disturbncs", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50411", "description": "[X]Psychogenic overeating", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50y00", "description": "[X]Other eating disorders", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50y11", "description": "[X]Pica in adults", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu50z00", "description": "[X]Eating disorder, unspecified", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Fy05.00", "description": "Nocturnal sleep-related eating disorder", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R030.00", "description": "[D]Anorexia", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R030z00", "description": "[D]Anorexia NOS", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036.00", "description": "[D]Polyphagia", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036000", "description": "[D]Excessive eating", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036011", "description": "[D]Bulimia NOS", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036100", "description": "[D]Hyperalimentation", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "R036z00", "description": "[D]Polyphagia NOS", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "SN42100", "description": "Starvation", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "U1B3.11", "description": "[X]Starvation", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Z4B5.00", "description": "Eating disorder counselling", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "ZC2CD00", "description": "Dietary advice for eating disorder", "attributes": { "Entity type": "res38: Eating disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/1vp1-j953", "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": 1402, "version_name": "Eating Disorder", "version_date": "2021-10-06T16:30:43.437034Z", "is_published": true, "is_latest": true } ] } ]