[
  {
    "phenotype_id": "PH870",
    "phenotype_version_id": 1819,
    "name": "AIDS",
    "definition": "Background:\n\nSelf-harm is a major risk factor for suicide, with older adults (older than 65 years) having reportedly greater suicidal intent than any other age group. With the aging population rising and paucity of research focus in this age group, the extent of the problem of self-harm needs to be established. In a primary care cohort of older adults we aimed to investigate the incidence of self-harm, subsequent clinical management, prevalence of mental and physical diagnoses, and unnatural-cause mortality risk, including suicide.\n\n\nMethods:\n\nThe UK Clinical Practice Research Datalink contains anonymised patient records from general practice that routinely capture clinical information pertaining to both primary and secondary care services. We identified 4124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001–14. We calculated standardised incidence and in 2854 adults with at least 12 months follow-up examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm. We estimated prevalence of mental and physical illness diagnoses before and after self-harm and, using Cox regression in a matched cohort, we examined cause-specific mortality risks.\n\n\nFindings:\n\nOverall incidence of self-harm in older adults aged 65 years and older was 4·1 per 10 000 person-years with stable gender-specific rates observed over the 13-year period. After self-harm, 335 (11·7%) of 2854 adults were referred to mental health services, 1692 (59·3%) were prescribed an antidepressant, and 336 (11·8%) were prescribed a tricyclic antidepressant (TCA). Having a diagnosed previous mental illness was twice as prevalent in the self-harm cohort as in the comparison cohort (prevalence ratio 2·10 [95% CI 2·03–2·17]) and with a previous physical health condition prevalence was 20% higher in the self-harm cohort compared to the comparison cohort (1·20 [1·17–1·23]). Adults from the self-harm cohort (n=2454) died from unnatural causes an estimated 20 times more frequently than the comparison cohort (n=48 921) during the first year. A markedly elevated risk of suicide (hazard ratio 145·4 [95% CI 53·9–392·3]) was observed in the self-harm cohort.\n\n\nInterpretation: \n\nWithin primary care, we have identified a group of older adults at high risk from unnatural death, particularly within the first year of self-harm. We have highlighted a high frequency of prescription of TCAs, known to be potentially fatally toxic in overdose. We emphasise the need for early intervention, careful alternative prescribing, and increased support when older adults consult after an episode of self-harm and with other health conditions.\n\n\n\n\n\n\n\n\n",
    "implementation": "",
    "publications": [
      {
        "doi": null,
        "details": "Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft, Self-harm in a primary care cohort of older people incidence, clinical management, and risk of suicide and other causes of death. Psychiatry, 5, 2018."
      }
    ],
    "validation": "",
    "citation_requirements": "",
    "created": "2022-04-04T07:07:23.583412Z",
    "author": "Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft",
    "collections": [
      {
        "name": "ClinicalCodes Repository",
        "value": 25
      },
      {
        "name": "Phenotype Library",
        "value": 18
      }
    ],
    "tags": null,
    "organisation": null,
    "world_access": 1,
    "updated": "2022-04-04T07:07:23.583436Z",
    "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": "ICD10 codes",
        "value": 4
      },
      {
        "name": "Read codes v2",
        "value": 5
      }
    ],
    "event_date_range": "01/01/2001 - 31/12/2014",
    "concept_information": [
      {
        "concept_id": 2620,
        "concept_version_id": 6653,
        "concept_name": "AIDS - Primary Care",
        "coding_system": {
          "id": 5,
          "name": "Read codes v2",
          "description": "Read codes v2"
        },
        "phenotype_id": "PH870",
        "phenotype_version_id": 1819,
        "phenotype_name": "AIDS",
        "code_attribute_header": [
          "Entity type",
          "Coding System (ICD-10 Read)",
          "Category"
        ],
        "codes": [
          {
            "code": "799MD",
            "description": "",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788.00",
            "description": "Acquired immune deficiency syndrome",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788100",
            "description": "Asymptomatic human immunodeficiency virus infection",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788200",
            "description": "HIV infection with persistent generalised lymphadenopathy",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788300",
            "description": "Human immunodeficiency virus with constitutional disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788400",
            "description": "Human immunodeficiency virus with neurological disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788500",
            "description": "Human immunodeficiency virus with secondary infection",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788600",
            "description": "Human immunodeficiency virus with secondary cancers",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788U00",
            "description": "HIV disease result/haematological+immunologic abnorms,NEC",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788W00",
            "description": "HIV disease resulting in unspecified malignant neoplasm",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788X00",
            "description": "HIV disease resulting/unspcf infectious+parasitic disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788y00",
            "description": "Human immunodeficiency virus with other clinical findings",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A788z00",
            "description": "Acquired human immunodeficiency virus infection syndrome NOS",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789.00",
            "description": "Human immunodef virus resulting in other disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789000",
            "description": "HIV disease resulting in mycobacterial infection",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789100",
            "description": "HIV disease resulting in cytomegaloviral disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789200",
            "description": "HIV disease resulting in candidiasis",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789300",
            "description": "HIV disease resulting in Pneumocystis carinii pneumonia",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789400",
            "description": "HIV disease resulting in multiple infections",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789500",
            "description": "HIV disease resulting in Kaposi's sarcoma",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789600",
            "description": "HIV disease resulting in Burkitt's lymphoma",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789800",
            "description": "HIV disease resulting in multiple malignant neoplasms",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789900",
            "description": "HIV disease resulting in lymphoid interstitial pneumonitis",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789A00",
            "description": "HIV disease resulting in wasting syndrome",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "A789X00",
            "description": "HIV dis reslt/oth mal neopl/lymph,h'matopoetc+reltd tissu",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuC.00",
            "description": "[X]Human immunodeficiency virus disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuC100",
            "description": "[X]HIV disease resulting in other viral infections",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuC300",
            "description": "[X]HIV disease resulting in multiple infections",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuC400",
            "description": "[X]HIV disease resulting/other infectious+parasitic diseases",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuC600",
            "description": "[X]HIV disease resulting in other non-Hodgkin's lymphoma",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuCB00",
            "description": "[X]HIV disease result/haematological+immunologic abnorms,NEC",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuCC00",
            "description": "[X]HIV disease resulting in other specified conditions",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "AyuCD00",
            "description": "[X]Unspecified human immunodeficiency virus [HIV] disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          },
          {
            "code": "L7990A",
            "description": "",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "Read",
              "Category": "diagnostic"
            }
          }
        ]
      },
      {
        "concept_id": 2621,
        "concept_version_id": 6655,
        "concept_name": "AIDS - Primary Care",
        "coding_system": {
          "id": 4,
          "name": "ICD10 codes",
          "description": "ICD10 Codes"
        },
        "phenotype_id": "PH870",
        "phenotype_version_id": 1819,
        "phenotype_name": "AIDS",
        "code_attribute_header": [
          "Entity type",
          "Coding System (ICD-10 Read)",
          "Category"
        ],
        "codes": [
          {
            "code": "B20-B24",
            "description": "Human immunodeficiency virus (HIV) disease",
            "attributes": {
              "Entity type": "res69: aids",
              "Coding System (ICD-10 Read)": "ICD-10",
              "Category": "diagnostic"
            }
          }
        ]
      }
    ],
    "status": 2,
    "doi": "https://doi.org/10.48533/6rjj-1572",
    "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": 1819,
        "version_name": "AIDS",
        "version_date": "2022-04-04T07:07:23.609888Z",
        "is_published": true,
        "is_latest": true
      }
    ]
  }
]