Background:
Little is known about the clinical management of patients in primary care following self-harm.
Methods:
A 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.
Results:
Among 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.
Conclusions:
A 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.
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.
Code | Description | Entity type | Coding System (Multilex) | Category |
---|---|---|---|---|
10469020 | Abilify 5mg tablets (Sigma Pharmaceuticals Plc) | res36: Atypical APDs | Multilex | drug |
13768020 | Risperdal Consta 50mg powder and solvent for suspension for injection vials (Waymade Healthcare Plc) | res36: Atypical APDs | Multilex | drug |
209021 | Quetiapine 12.5mg/5ml oral solution | res36: Atypical APDs | Multilex | drug |
33610020 | Quetiapine 25mg/5ml oral solution | res36: Atypical APDs | Multilex | drug |
337021 | Asenapine 5mg sublingual tablets sugar free | res36: Atypical APDs | Multilex | drug |
341021 | Asenapine 10mg sublingual tablets sugar free | res36: Atypical APDs | Multilex | drug |
35008020 | Amisulpride 12.5mg/5ml oral solution | res36: Atypical APDs | Multilex | drug |
35010020 | Amisulpride 12.5mg/5ml oral suspension | res36: Atypical APDs | Multilex | drug |
3580020 | Olanzapine 2.5mg tablets (Aspire Pharma Ltd) | res36: Atypical APDs | Multilex | drug |
36328020 | Quetiapine 50mg/5ml oral suspension | res36: Atypical APDs | Multilex | drug |
36905020 | Risperidone 125micrograms/5ml oral solution | res36: Atypical APDs | Multilex | drug |
411021 | Amisulpride 25mg/5ml oral solution | res36: Atypical APDs | Multilex | drug |
42176020 | Quetiapine 25mg tablets (Zentiva) | res36: Atypical APDs | Multilex | drug |
447021 | Quetiapine 12.5mg/5ml oral suspension | res36: Atypical APDs | Multilex | drug |
49437020 | Risperdal 1mg tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
49438020 | Risperdal 2mg tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
49439020 | Risperdal 3mg tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
49489020 | Risperidone 4mg tablets | res36: Atypical APDs | Multilex | drug |
49490020 | Risperidone 1mg/ml oral solution sugar free | res36: Atypical APDs | Multilex | drug |
49491020 | Risperidone 6mg tablets | res36: Atypical APDs | Multilex | drug |
50780020 | Zotepine 25mg tablets | res36: Atypical APDs | Multilex | drug |
50781020 | Zotepine 50mg tablets | res36: Atypical APDs | Multilex | drug |
50782020 | Zotepine 100mg tablets | res36: Atypical APDs | Multilex | drug |
53727020 | Risperidone 1mg tablets | res36: Atypical APDs | Multilex | drug |
53728020 | Risperidone 2mg tablets | res36: Atypical APDs | Multilex | drug |
53729020 | Risperidone 3mg tablets | res36: Atypical APDs | Multilex | drug |
55209020 | Zoleptil 25 tablets (Movianto UK Ltd) | res36: Atypical APDs | Multilex | drug |
55210020 | Zoleptil 50 tablets (Movianto UK Ltd) | res36: Atypical APDs | Multilex | drug |
55972020 | Olanzapine 15mg Orodispersible tablet | res36: Atypical APDs | Multilex | drug |
58203020 | Zyprexa 15mg tablets (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
589021 | Zalasta 5mg orodispersible tablets (Consilient Health Ltd) | res36: Atypical APDs | Multilex | drug |
59434020 | Olanzapine 15mg tablets | res36: Atypical APDs | Multilex | drug |
65788020 | Risperidone 50mg powder and solvent for suspension for injection vials | res36: Atypical APDs | Multilex | drug |
68217020 | Amisulpride 50mg tablets (Zentiva) | res36: Atypical APDs | Multilex | drug |
68222020 | Amisulpride 100mg tablets (Zentiva) | res36: Atypical APDs | Multilex | drug |
68224020 | Amisulpride 200mg tablets (Zentiva) | res36: Atypical APDs | Multilex | drug |
69302020 | Amisulpride 200mg tablets (A A H Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
709021 | Olanzapine 5mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
711021 | Olanzapine 5mg orodispersible tablets | res36: Atypical APDs | Multilex | drug |
713021 | Olanzapine 5mg oral lyophilisates sugar free | res36: Atypical APDs | Multilex | drug |
715021 | Olanzapine 10mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
717021 | Olanzapine 10mg orodispersible tablets | res36: Atypical APDs | Multilex | drug |
719021 | Olanzapine 10mg oral lyophilisates sugar free | res36: Atypical APDs | Multilex | drug |
723021 | Olanzapine 15mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
725021 | Olanzapine 15mg orodispersible tablets | res36: Atypical APDs | Multilex | drug |
72576020 | Clozaril 25mg tablets (Novartis Pharmaceuticals UK Ltd) | res36: Atypical APDs | Multilex | drug |
72577020 | Clozaril 100mg tablets (Novartis Pharmaceuticals UK Ltd) | res36: Atypical APDs | Multilex | drug |
72580020 | Clozapine 25mg tablets | res36: Atypical APDs | Multilex | drug |
72581020 | Clozapine 100mg tablets | res36: Atypical APDs | Multilex | drug |
727021 | Olanzapine 15mg oral lyophilisates sugar free | res36: Atypical APDs | Multilex | drug |
729021 | Olanzapine 20mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
731021 | Olanzapine 20mg orodispersible tablets | res36: Atypical APDs | Multilex | drug |
733021 | Olanzapine 20mg oral lyophilisates sugar free | res36: Atypical APDs | Multilex | drug |
73439020 | Remoxipride 150mg capsule | res36: Atypical APDs | Multilex | drug |
73440020 | Remoxipride 300mg capsule | res36: Atypical APDs | Multilex | drug |
73441020 | Remoxipride 75mg capsule | res36: Atypical APDs | Multilex | drug |
73474020 | Roxiam 150mg Capsule (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
73475020 | Roxiam 300mg Capsule (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
73798020 | Risperdal 4mg tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
73799020 | Risperdal 1mg/ml liquid (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
73800020 | Risperdal 6mg tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
74786020 | Risperidone 500microgram tablets (Actavis UK Ltd) | res36: Atypical APDs | Multilex | drug |
74841020 | Risperidone 1mg tablets (Teva UK Ltd) | res36: Atypical APDs | Multilex | drug |
74927020 | Risperidone 500microgram tablets (A A H Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
77501020 | Risperdal Quicklet 2mg orodispersible tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
77550020 | Risperdal Consta 37.5mg powder and solvent for suspension for injection vials (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
77749020 | Risperdal 500microgram tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
77912020 | Risperidone 500microgram tablets | res36: Atypical APDs | Multilex | drug |
78753020 | Risperdal Consta 25mg powder and solvent for suspension for injection vials (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
78912020 | Zyprexa 5mg Velotabs (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
78913020 | Zyprexa 10mg Velotabs (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
79348020 | Solian 100mg/ml oral solution (Sanofi) | res36: Atypical APDs | Multilex | drug |
79476020 | Risperidone 1mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
79499020 | Zyprexa 15mg Velotabs (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
80139020 | Amisulpride 100mg tablets | res36: Atypical APDs | Multilex | drug |
80154020 | Solian 100 tablets (Sanofi) | res36: Atypical APDs | Multilex | drug |
81008020 | Zyprexa 2.5mg tablets (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
81014020 | Olanzapine 2.5mg tablets | res36: Atypical APDs | Multilex | drug |
81015020 | Olanzapine 5mg Orodispersible tablet | res36: Atypical APDs | Multilex | drug |
81016020 | Olanzapine 10mg Orodispersible tablet | res36: Atypical APDs | Multilex | drug |
81543020 | Risperidone 2mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
81545020 | Risperdal Quicklet 1mg orodispersible tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
81945020 | Amisulpride 100mg/ml oral solution sugar free | res36: Atypical APDs | Multilex | drug |
82616020 | Risperdal Consta 50mg powder and solvent for suspension for injection vials (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
82827020 | Sertindole 4mg tablets | res36: Atypical APDs | Multilex | drug |
82828020 | Sertindole 12mg tablets | res36: Atypical APDs | Multilex | drug |
82829020 | Sertindole 16mg tablets | res36: Atypical APDs | Multilex | drug |
82831020 | Sertindole 20mg tablets | res36: Atypical APDs | Multilex | drug |
82835020 | Serdolect 4mg tablets (Lundbeck Ltd) | res36: Atypical APDs | Multilex | drug |
82836020 | Serdolect 12mg tablets (Lundbeck Ltd) | res36: Atypical APDs | Multilex | drug |
82837020 | Serdolect 16mg tablets (Lundbeck Ltd) | res36: Atypical APDs | Multilex | drug |
83397020 | Zyprexa 5mg tablets (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
83398020 | Zyprexa 7.5mg tablets (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
83399020 | Zyprexa 10mg tablets (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
83403020 | Olanzapine 5mg tablets | res36: Atypical APDs | Multilex | drug |
83404020 | Olanzapine 7.5mg tablets | res36: Atypical APDs | Multilex | drug |
83405020 | Olanzapine 10mg tablets | res36: Atypical APDs | Multilex | drug |
84528020 | Roxiam ir 75mg Capsule (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
85202020 | Quetiapine Starter Pack | res36: Atypical APDs | Multilex | drug |
85203020 | Quetiapine 25mg tablets | res36: Atypical APDs | Multilex | drug |
85204020 | Quetiapine 100mg tablets | res36: Atypical APDs | Multilex | drug |
85206020 | Quetiapine 200mg tablets | res36: Atypical APDs | Multilex | drug |
85207020 | Quetiapine 150mg tablets | res36: Atypical APDs | Multilex | drug |
85212020 | Seroquel 25mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
85213020 | Seroquel 100mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
85215020 | Seroquel 200mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
85216020 | Seroquel 150mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
85992020 | Amisulpride 50mg tablets | res36: Atypical APDs | Multilex | drug |
85993020 | Amisulpride 200mg tablets | res36: Atypical APDs | Multilex | drug |
85994020 | Amisulpride 400mg tablets | res36: Atypical APDs | Multilex | drug |
85999020 | Solian 50 tablets (Sanofi) | res36: Atypical APDs | Multilex | drug |
86000020 | Solian 200 tablets (Sanofi) | res36: Atypical APDs | Multilex | drug |
86001020 | Solian 400 tablets (Sanofi) | res36: Atypical APDs | Multilex | drug |
86494020 | Risperidone 25mg powder and solvent for suspension for injection vials | res36: Atypical APDs | Multilex | drug |
86496020 | Risperidone 37.5mg powder and solvent for suspension for injection vials | res36: Atypical APDs | Multilex | drug |
87045020 | Quetiapine 300mg tablets | res36: Atypical APDs | Multilex | drug |
87047020 | Seroquel 300mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
87556020 | Olanzapine 10mg powder for solution for injection vials | res36: Atypical APDs | Multilex | drug |
87558020 | Zyprexa 10mg powder for solution for injection vials (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
87944020 | Aripiprazole 10mg tablets | res36: Atypical APDs | Multilex | drug |
87946020 | Aripiprazole 15mg tablets | res36: Atypical APDs | Multilex | drug |
87948020 | Aripiprazole 30mg tablets | res36: Atypical APDs | Multilex | drug |
87950020 | Abilify 10mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
87952020 | Abilify 15mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
87954020 | Abilify 30mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
88167020 | Denzapine 25mg tablets (Britannia Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
88169020 | Denzapine 100mg tablets (Britannia Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
88666020 | Aripiprazole 5mg tablets | res36: Atypical APDs | Multilex | drug |
88668020 | Abilify 5mg tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
88804020 | Zaponex 25mg tablets (Teva UK Ltd) | res36: Atypical APDs | Multilex | drug |
88806020 | Zaponex 100mg tablets (Teva UK Ltd) | res36: Atypical APDs | Multilex | drug |
88875020 | Risperidone 500microgram orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
88877020 | Risperdal Quicklet 500microgram orodispersible tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
89950020 | Amisulpride 25mg/5ml oral suspension | res36: Atypical APDs | Multilex | drug |
90165020 | Olanzapine 20mg Orodispersible tablet | res36: Atypical APDs | Multilex | drug |
90167020 | Zyprexa 20mg Velotabs (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
91139020 | Aripiprazole 10mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
91141020 | Aripiprazole 15mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
91143020 | Aripiprazole 1mg/ml oral solution | res36: Atypical APDs | Multilex | drug |
91145020 | Abilify 10mg orodispersible tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
91147020 | Abilify 15mg orodispersible tablets (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
91149020 | Abilify 1mg/ml oral solution (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
92053020 | Olanzapine 20mg tablets | res36: Atypical APDs | Multilex | drug |
92055020 | Zyprexa 20mg tablets (Eli Lilly and Company Ltd) | res36: Atypical APDs | Multilex | drug |
92717020 | Risperidone 3mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
92721020 | Risperidone 4mg orodispersible tablets sugar free | res36: Atypical APDs | Multilex | drug |
92723020 | Risperdal Quicklet 3mg orodispersible tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
92725020 | Risperdal Quicklet 4mg orodispersible tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
93739020 | Paliperidone 3mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
93741020 | Paliperidone 6mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
93743020 | Paliperidone 9mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
93747020 | Invega 6mg modified-release tablets (Janssen-Cilag Ltd) | res36: Atypical APDs | Multilex | drug |
94787020 | Quetiapine 50mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
94789020 | Quetiapine 200mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
94791020 | Quetiapine 300mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
94793020 | Quetiapine 400mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
94971020 | Aripiprazole 9.75mg/1.3ml solution for injection vials | res36: Atypical APDs | Multilex | drug |
94973020 | Abilify 9.75mg/1.3ml solution for injection vials (Otsuka Pharmaceuticals (U.K.) Ltd) | res36: Atypical APDs | Multilex | drug |
95787020 | Seroquel XL 50mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
95789020 | Seroquel XL 200mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
95791020 | Seroquel XL 300mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
95793020 | Seroquel XL 400mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
97145020 | Clozapine 50mg tablets | res36: Atypical APDs | Multilex | drug |
97147020 | Denzapine 50mg tablets (Britannia Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
97149020 | Clozapine 200mg tablets | res36: Atypical APDs | Multilex | drug |
97151020 | Denzapine 200mg tablets (Britannia Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
97153020 | Clozapine 50mg/ml oral suspension sugar free | res36: Atypical APDs | Multilex | drug |
97155020 | Denzapine 50mg/ml oral suspension (Britannia Pharmaceuticals Ltd) | res36: Atypical APDs | Multilex | drug |
97203020 | Quetiapine 100mg/5ml oral solution | res36: Atypical APDs | Multilex | drug |
97205020 | Quetiapine 100mg/5ml oral suspension | res36: Atypical APDs | Multilex | drug |
98873020 | Quetiapine 150mg modified-release tablets | res36: Atypical APDs | Multilex | drug |
98875020 | Seroquel XL 150mg tablets (AstraZeneca UK Ltd) | res36: Atypical APDs | Multilex | drug |
99745020 | Quetiapine 25mg/5ml oral suspension | res36: Atypical APDs | Multilex | drug |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH365/version/730/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH365/version/730/detail/?format=json |
R Package |
|
To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH365/version/730/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH365/version/730/export/codes/?format=json |
CSV | site_root/phenotypes/PH365/version/730/export/codes/ |
R Package |
|
Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
730 | Atypical APDs | ieuan.scanlon | 2021-10-06 | currently shown |
Export - export all codes into a csv file/JSON/XML for the current phenotype version.
Print - Print page.