[ { "phenotype_id": "PH705", "phenotype_version_id": 1410, "name": "Personality 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": "2021-10-06T16:30:55.850165Z", "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": "2021-10-06T16:30:55.850192Z", "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": "Read codes v2", "value": 5 } ], "event_date_range": "01/01/2002 - 31/12/2011", "concept_information": [ { "concept_id": 2125, "concept_version_id": 5388, "concept_name": "Personality Disorder - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH705", "phenotype_version_id": 1410, "phenotype_name": "Personality Disorder", "code_attribute_header": [ "Entity type", "Category", "Coding System (Read)" ], "codes": [ { "code": "E21..00", "description": "Personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E210.00", "description": "Paranoid personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211.00", "description": "Affective personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211000", "description": "Unspecified affective personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21..11", "description": "Neurotic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211100", "description": "Hypomanic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211200", "description": "Depressive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211300", "description": "Cyclothymic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E211z00", "description": "Affective personality disorder NOS", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E212.00", "description": "Schizoid personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E212000", "description": "Unspecified schizoid personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E212z00", "description": "Schizoid personality disorder NOS", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E213.00", "description": "Explosive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214.00", "description": "Compulsive personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214000", "description": "Anankastic personality", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214.11", "description": "Anancastic personality", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E214z00", "description": "Compulsive personality disorder NOS", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215.00", "description": "Histrionic personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215000", "description": "Unspecified histrionic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215.11", "description": "Hysterical personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E215z00", "description": "Histrionic personality disorder NOS", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E216.00", "description": "Inadequate personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E217.00", "description": "Antisocial or sociopathic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y.00", "description": "Other personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y000", "description": "Narcissistic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y100", "description": "Avoidant personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y200", "description": "Borderline personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y300", "description": "Passive-aggressive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y400", "description": "Eccentric personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y500", "description": "Immature personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y600", "description": "Masochistic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21y700", "description": "Psychoneurotic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21yz00", "description": "Other personality disorder NOS", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21z.00", "description": "Personality disorder NOS", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "E21z.11", "description": "Psychopathic personality", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu06000", "description": "[X]Organic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu06011", "description": "[X]Organic pseudopsychopathic personality", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu21.17", "description": "[X]Pseudopsychopathic schizophrenia", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu21.18", "description": "[X]Schizotypal personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu34011", "description": "[X]Affective personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu34112", "description": "[X]Depressive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60.00", "description": "[X]Specific personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60000", "description": "[X]Paranoid personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60013", "description": "[X]Querulant personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60014", "description": "[X]Sensitive paranoid personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60100", "description": "[X]Schizoid personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60200", "description": "[X]Dissocial personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60212", "description": "[X]Antisocial personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60213", "description": "[X]Asocial personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60214", "description": "[X]Psychopathic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60215", "description": "[X]Sociopathic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60300", "description": "[X]Emotionally unstable personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60311", "description": "[X]Aggressive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60312", "description": "[X]Borderline personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60313", "description": "[X]Explosive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60400", "description": "[X]Histrionic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60411", "description": "[X]Hysterical personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60412", "description": "[X]Psychoinfantile personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60500", "description": "[X]Anankastic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60511", "description": "[X]Compulsive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60512", "description": "[X]Obsessional personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60513", "description": "[X]Obsessive-compulsive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60600", "description": "[X]Anxious [avoidant] personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60700", "description": "[X]Dependent personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60711", "description": "[X]Asthenic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60712", "description": "[X]Inadequate personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60713", "description": "[X]Passive personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60714", "description": "[X]Self defeating personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60y00", "description": "[X]Other specific personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60y11", "description": "[X]Eccentric personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60y12", "description": "[X]Haltlose type personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60y13", "description": "[X]Immature personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60y14", "description": "[X]Narcissistic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60y16", "description": "[X]Psychoneurotic personality disorder", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu60z00", "description": "[X]Personality disorder, unspecified", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu61.00", "description": "[X]Mixed and other personality disorders", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu84511", "description": "[X]Autistic psychopathy", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } }, { "code": "Eu94211", "description": "[X]Affectionless psychopathy", "attributes": { "Entity type": "res38: Personality disorder", "Category": "diagnostic", "Coding System (Read)": "Read" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/25p4-cs12", "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": 1410, "version_name": "Personality Disorder", "version_date": "2021-10-06T16:30:55.878006Z", "is_published": true, "is_latest": true } ] } ]