[
  {
    "phenotype_id": "PH829",
    "phenotype_version_id": 1737,
    "name": "Anxiety",
    "definition": "Background:\n\nThe Covid-19 pandemic has adversely affected population mental health.\n\n\nMethods:\n\nUsing electronic health records from 1714 UK general practices registered with the Clinical Practice Research Datalink we examined incidence and event rates of depression and anxiety disorders, self-harm, prescriptions for antidepressants and benzodiazepines and GP referrals to mental health services per 100,000 person-months, before, during and after the peak of the Covid-19 emergency. Analyses were stratified by gender, age group and practice-level Index of Multiple Deprivation quintile.\n\n\nFindings:\n\nIn April 2020, primary care-recorded incident depression reduced by 43·6% (95% CI 39·0% to 47·9%), anxiety disorders by 48·2% (CI 44·6% to 51·5%) and antidepressant prescribing by 36·2% (CI 33·7% to 38·6%) compared to expected rates based on prior trends. Reductions in first diagnoses of depression and anxiety disorders were particularly stark for working-age adults and patients registered at practices in more deprived areas. Self-harm incidence was 38·5% (CI 35·7% to 41·3%) lower than expected in April 2020. Total self-harm contacts fell by 28·2% (CI 25·5% to 30·8%). Rates of both incident and any self-harm remained around thirty percent lower than expected up to June 2020.\n\n\nInterpretation:\n\nOur findings reveal a stark treatment gap that was greater for first diagnoses of depression and anxiety disorders in working age adults, for practice populations in deprived areas, and for self-harm. Consequences could include more patients subsequently presenting with greater acuity and severity of mental illness and rising rates of non-fatal self-harm and suicide.\n\n\n\n\n\n\n\n\n",
    "implementation": "",
    "publications": [
      {
        "doi": null,
        "details": "Matthew J Carr, Sarah Steeg, Roger T Webb, Nav Kapur, Carolyn A Chew-Graham, Kathryn M Abel, Holly Hope, Matthias Pierce, Darren M. Ashcroft, Primary care contact for mental illness and self-harm before during and after the peak of the Covid-19 pandemic in the UK cohort study of 13 million individual. PrePrint not peer reviewed, 2020."
      }
    ],
    "validation": "",
    "citation_requirements": "",
    "created": "2022-04-04T07:05:55.562409Z",
    "author": "Matthew J Carr, Sarah Steeg, Roger T Webb, Nav Kapur, Carolyn A Chew-Graham, Kathryn M Abel, Holly Hope, Matthias Pierce, Darren M. Ashcroft",
    "collections": [
      {
        "name": "ClinicalCodes Repository",
        "value": 25
      },
      {
        "name": "Phenotype Library",
        "value": 18
      }
    ],
    "tags": null,
    "organisation": null,
    "world_access": 1,
    "updated": "2022-04-04T07:05:55.562434Z",
    "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": "01/01/2010 - 30/06/2020",
    "concept_information": [
      {
        "concept_id": 2584,
        "concept_version_id": 6581,
        "concept_name": "Anxiety - Primary Care",
        "coding_system": {
          "id": 5,
          "name": "Read codes v2",
          "description": "Read codes v2"
        },
        "phenotype_id": "PH829",
        "phenotype_version_id": 1737,
        "phenotype_name": "Anxiety",
        "code_attribute_header": [
          "Entity type",
          "Category",
          "Coding System (Read)"
        ],
        "codes": [
          {
            "code": "1B1V.00",
            "description": "C/O - panic attack",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "225J.00",
            "description": "O/E - panic attack",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "8CAZ000",
            "description": "Patient given advice about management of anxiety",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "8G52.00",
            "description": "Antiphobic therapy",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "8G94.00",
            "description": "Anxiety management training",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "8HHp.00",
            "description": "Referral for guided self-help for anxiety",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "8IH5300",
            "description": "Referral for guided self-help for anxiety declined",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E200100",
            "description": "Panic disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E200111",
            "description": "Panic attack",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E200200",
            "description": "Generalised anxiety disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E200300",
            "description": "Anxiety with depression",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E200400",
            "description": "Chronic anxiety",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E200500",
            "description": "Recurrent anxiety",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202.00",
            "description": "Phobic disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202000",
            "description": "Phobia unspecified",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202100",
            "description": "Agoraphobia with panic attacks",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202.11",
            "description": "Social phobic disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202.12",
            "description": "Phobic anxiety",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202199",
            "description": "Agoraphobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202200",
            "description": "Agoraphobia without mention of panic attacks",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202299",
            "description": "Agoraphobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202300",
            "description": "Social phobia, fear of eating in public",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202400",
            "description": "Social phobia, fear of public speaking",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202500",
            "description": "Social phobia, fear of public washing",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202600",
            "description": "Acrophobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202800",
            "description": "Claustrophobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202.99",
            "description": "Phobic state",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202z00",
            "description": "Phobic disorder NOS",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202z98",
            "description": "Needle phobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E202z99",
            "description": "Other phobias",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E203.00",
            "description": "Obsessive-compulsive disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E203000",
            "description": "Compulsive neurosis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E203100",
            "description": "Obsessional neurosis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E203.11",
            "description": "Anancastic neurosis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E203z00",
            "description": "Obsessive-compulsive disorder NOS",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E20z.00",
            "description": "Neurotic disorder NOS",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E28z.12",
            "description": "Flying phobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E29y199",
            "description": "Chron post-traum stress dis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu05400",
            "description": "[X]Organic anxiety disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu34114",
            "description": "[X]Persistant anxiety depression",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40.00",
            "description": "[X]Phobic anxiety disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40000",
            "description": "[X]Agoraphobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40011",
            "description": "[X]Agoraphobia without history of panic disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40012",
            "description": "[X]Panic disorder with agoraphobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40100",
            "description": "[X]Social phobias",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40111",
            "description": "[X]Anthropophobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40112",
            "description": "[X]Social neurosis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40200",
            "description": "[X]Specific (isolated) phobias",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40211",
            "description": "[X]Acrophobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40212",
            "description": "[X]Animal phobias",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40213",
            "description": "[X]Claustrophobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40214",
            "description": "[X]Simple phobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40299",
            "description": "Needle phobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40300",
            "description": "[X]Needle phobia",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40y00",
            "description": "[X]Other phobic anxiety disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40z00",
            "description": "[X]Phobic anxiety disorder, unspecified",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40z11",
            "description": "[X]Phobia NOS",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu40z12",
            "description": "[X]Phobic state NOS",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41.00",
            "description": "[X]Other anxiety disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41000",
            "description": "[X]Panic disorder [episodic paroxysmal anxiety]",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41011",
            "description": "[X]Panic attack",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41012",
            "description": "[X]Panic state",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41100",
            "description": "[X]Generalized anxiety disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41111",
            "description": "[X]Anxiety neurosis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41200",
            "description": "[X]Mixed anxiety and depressive disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41211",
            "description": "[X]Mild anxiety depression",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41300",
            "description": "[X]Other mixed anxiety disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41y00",
            "description": "[X]Other specified anxiety disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41y11",
            "description": "[X]Anxiety hysteria",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu41z00",
            "description": "[X]Anxiety disorder, unspecified",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu42.00",
            "description": "[X]Obsessive - compulsive disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu42000",
            "description": "[X]Predominantly obsessional thoughts or ruminations",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu42.12",
            "description": "[X]Obsessive-compulsive neurosis",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu42200",
            "description": "[X]Mixed obsessional thoughts and acts",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu42y00",
            "description": "[X]Other obsessive-compulsive disorders",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu42z00",
            "description": "[X]Obsessive-compulsive disorder, unspecified",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu43013",
            "description": "[X]Combat fatigue",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu43100",
            "description": "[X]Post - traumatic stress disorder",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu43300",
            "description": "[X]Acute post-traumatic stress disorder follow military comb",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu43400",
            "description": "[X]Chron post-traumatic stress disorder follow military comb",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu43500",
            "description": "[X]Delayed post-traumat stress disorder follow military comb",
            "attributes": {
              "Entity type": "res173: Anxiety (Read codes)",
              "Category": "diagnostic",
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    ],
    "status": 2,
    "doi": "https://doi.org/10.48533/91hp-fm62",
    "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.",
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    },
    "versions": [
      {
        "version_id": 1737,
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        "version_date": "2022-04-04T07:05:55.590073Z",
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]