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Bipolar Disorder

Matthew J Carr, Darren M Ashscroft, Evangelos Kontopantelis, David While, Yvonne Awenant, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb

Type
Disease or Syndrome
ID
PH369
Version ID
738
Data Sources
Valid event data range
01/01/2001 - 31/12/2012
Sex
Female, Male
Agreement Date
2016-03-08
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

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.

Publications

  • 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.

Clinical Code List

Rows: 111
Code Description Entity type Category Coding System (Read)
146D.00 H/O: manic depressive disorder res36: Bipolar disorder diagnostic Read
1S42.00 Manic mood res36: Bipolar disorder diagnostic Read
6657.00 On lithium res36: Bipolar disorder diagnostic Read
6657.11 Lithium monitoring res36: Bipolar disorder diagnostic Read
6657.12 Started lithium res36: Bipolar disorder diagnostic Read
E11..00 Affective psychoses res36: Bipolar disorder diagnostic Read
E11..11 Bipolar psychoses res36: Bipolar disorder diagnostic Read
E11..13 Manic psychoses res36: Bipolar disorder diagnostic Read
E110.00 Manic disorder, single episode res36: Bipolar disorder diagnostic Read
E110.11 Hypomanic psychoses res36: Bipolar disorder diagnostic Read
E110000 Single manic episode, unspecified res36: Bipolar disorder diagnostic Read
E110100 Single manic episode, mild res36: Bipolar disorder diagnostic Read
E110200 Single manic episode, moderate res36: Bipolar disorder diagnostic Read
E110300 Single manic episode, severe without mention of psychosis res36: Bipolar disorder diagnostic Read
E110400 Single manic episode, severe, with psychosis res36: Bipolar disorder diagnostic Read
E110600 Single manic episode in full remission res36: Bipolar disorder diagnostic Read
E110z00 Manic disorder, single episode NOS res36: Bipolar disorder diagnostic Read
E111.00 Recurrent manic episodes res36: Bipolar disorder diagnostic Read
E111000 Recurrent manic episodes, unspecified res36: Bipolar disorder diagnostic Read
E111100 Recurrent manic episodes, mild res36: Bipolar disorder diagnostic Read
E111200 Recurrent manic episodes, moderate res36: Bipolar disorder diagnostic Read
E111300 Recurrent manic episodes, severe without mention psychosis res36: Bipolar disorder diagnostic Read
E111400 Recurrent manic episodes, severe, with psychosis res36: Bipolar disorder diagnostic Read
E111500 Recurrent manic episodes, partial or unspecified remission res36: Bipolar disorder diagnostic Read
E111600 Recurrent manic episodes, in full remission res36: Bipolar disorder diagnostic Read
E111z00 Recurrent manic episode NOS res36: Bipolar disorder diagnostic Read
E114.00 Bipolar affective disorder, currently manic res36: Bipolar disorder diagnostic Read
E114.11 Manic-depressive - now manic res36: Bipolar disorder diagnostic Read
E114000 Bipolar affective disorder, currently manic, unspecified res36: Bipolar disorder diagnostic Read
E114100 Bipolar affective disorder, currently manic, mild res36: Bipolar disorder diagnostic Read
E114200 Bipolar affective disorder, currently manic, moderate res36: Bipolar disorder diagnostic Read
E114300 Bipolar affect disord, currently manic, severe, no psychosis res36: Bipolar disorder diagnostic Read
E114400 Bipolar affect disord, currently manic,severe with psychosis res36: Bipolar disorder diagnostic Read
E114500 Bipolar affect disord,currently manic, part/unspec remission res36: Bipolar disorder diagnostic Read
E114600 Bipolar affective disorder, currently manic, full remission res36: Bipolar disorder diagnostic Read
E114z00 Bipolar affective disorder, currently manic, NOS res36: Bipolar disorder diagnostic Read
E115.00 Bipolar affective disorder, currently depressed res36: Bipolar disorder diagnostic Read
E115.11 Manic-depressive - now depressed res36: Bipolar disorder diagnostic Read
E115000 Bipolar affective disorder, currently depressed, unspecified res36: Bipolar disorder diagnostic Read
E115100 Bipolar affective disorder, currently depressed, mild res36: Bipolar disorder diagnostic Read
E115200 Bipolar affective disorder, currently depressed, moderate res36: Bipolar disorder diagnostic Read
E115300 Bipolar affect disord, now depressed, severe, no psychosis res36: Bipolar disorder diagnostic Read
E115400 Bipolar affect disord, now depressed, severe with psychosis res36: Bipolar disorder diagnostic Read
E115500 Bipolar affect disord, now depressed, part/unspec remission res36: Bipolar disorder diagnostic Read
E115600 Bipolar affective disorder, now depressed, in full remission res36: Bipolar disorder diagnostic Read
E115z00 Bipolar affective disorder, currently depressed, NOS res36: Bipolar disorder diagnostic Read
E116.00 Mixed bipolar affective disorder res36: Bipolar disorder diagnostic Read
E116000 Mixed bipolar affective disorder, unspecified res36: Bipolar disorder diagnostic Read
E116100 Mixed bipolar affective disorder, mild res36: Bipolar disorder diagnostic Read
E116200 Mixed bipolar affective disorder, moderate res36: Bipolar disorder diagnostic Read
E116300 Mixed bipolar affective disorder, severe, without psychosis res36: Bipolar disorder diagnostic Read
E116400 Mixed bipolar affective disorder, severe, with psychosis res36: Bipolar disorder diagnostic Read
E116500 Mixed bipolar affective disorder, partial/unspec remission res36: Bipolar disorder diagnostic Read
E116600 Mixed bipolar affective disorder, in full remission res36: Bipolar disorder diagnostic Read
E116z00 Mixed bipolar affective disorder, NOS res36: Bipolar disorder diagnostic Read
E117.00 Unspecified bipolar affective disorder res36: Bipolar disorder diagnostic Read
E117000 Unspecified bipolar affective disorder, unspecified res36: Bipolar disorder diagnostic Read
E117100 Unspecified bipolar affective disorder, mild res36: Bipolar disorder diagnostic Read
E117200 Unspecified bipolar affective disorder, moderate res36: Bipolar disorder diagnostic Read
E117300 Unspecified bipolar affective disorder, severe, no psychosis res36: Bipolar disorder diagnostic Read
E117400 Unspecified bipolar affective disorder,severe with psychosis res36: Bipolar disorder diagnostic Read
E117500 Unspecified bipolar affect disord, partial/unspec remission res36: Bipolar disorder diagnostic Read
E117600 Unspecified bipolar affective disorder, in full remission res36: Bipolar disorder diagnostic Read
E117z00 Unspecified bipolar affective disorder, NOS res36: Bipolar disorder diagnostic Read
E11y.00 Other and unspecified manic-depressive psychoses res36: Bipolar disorder diagnostic Read
E11y000 Unspecified manic-depressive psychoses res36: Bipolar disorder diagnostic Read
E11y100 Atypical manic disorder res36: Bipolar disorder diagnostic Read
E11y300 Other mixed manic-depressive psychoses res36: Bipolar disorder diagnostic Read
E11yz00 Other and unspecified manic-depressive psychoses NOS res36: Bipolar disorder diagnostic Read
Eu3..00 [X]Mood - affective disorders res36: Bipolar disorder diagnostic Read
Eu30.00 [X]Manic episode res36: Bipolar disorder diagnostic Read
Eu30.11 [X]Bipolar disorder, single manic episode res36: Bipolar disorder diagnostic Read
Eu30000 [X]Hypomania res36: Bipolar disorder diagnostic Read
Eu30100 [X]Mania without psychotic symptoms res36: Bipolar disorder diagnostic Read
Eu30200 [X]Mania with psychotic symptoms res36: Bipolar disorder diagnostic Read
Eu30211 [X]Mania with mood-congruent psychotic symptoms res36: Bipolar disorder diagnostic Read
Eu30212 [X]Mania with mood-incongruent psychotic symptoms res36: Bipolar disorder diagnostic Read
Eu30y00 [X]Other manic episodes res36: Bipolar disorder diagnostic Read
Eu30z00 [X]Manic episode, unspecified res36: Bipolar disorder diagnostic Read
Eu30z11 [X]Mania NOS res36: Bipolar disorder diagnostic Read
Eu31.00 [X]Bipolar affective disorder res36: Bipolar disorder diagnostic Read
Eu31.11 [X]Manic-depressive illness res36: Bipolar disorder diagnostic Read
Eu31.12 [X]Manic-depressive psychosis res36: Bipolar disorder diagnostic Read
Eu31.13 [X]Manic-depressive reaction res36: Bipolar disorder diagnostic Read
Eu31000 [X]Bipolar affective disorder, current episode hypomanic res36: Bipolar disorder diagnostic Read
Eu31100 [X]Bipolar affect disorder cur epi manic wout psychotic symp res36: Bipolar disorder diagnostic Read
Eu31200 [X]Bipolar affect disorder cur epi manic with psychotic symp res36: Bipolar disorder diagnostic Read
Eu31300 [X]Bipolar affect disorder cur epi mild or moderate depressn res36: Bipolar disorder diagnostic Read
Eu31400 [X]Bipol aff disord, curr epis sev depress, no psychot symp res36: Bipolar disorder diagnostic Read
Eu31500 [X]Bipolar affect dis cur epi severe depres with psyc symp res36: Bipolar disorder diagnostic Read
Eu31600 [X]Bipolar affective disorder, current episode mixed res36: Bipolar disorder diagnostic Read
Eu31700 [X]Bipolar affective disorder, currently in remission res36: Bipolar disorder diagnostic Read
Eu31y00 [X]Other bipolar affective disorders res36: Bipolar disorder diagnostic Read
Eu31y11 [X]Bipolar II disorder res36: Bipolar disorder diagnostic Read
Eu31y12 [X]Recurrent manic episodes res36: Bipolar disorder diagnostic Read
Eu31z00 [X]Bipolar affective disorder, unspecified res36: Bipolar disorder diagnostic Read
Eu33213 [X]Manic-depress psychosis,depressd,no psychotic symptoms res36: Bipolar disorder diagnostic Read
Eu33312 [X]Manic-depress psychosis,depressed type+psychotic symptoms res36: Bipolar disorder diagnostic Read
Eu34.00 [X]Persistent mood affective disorders res36: Bipolar disorder diagnostic Read
Eu34000 [X]Cyclothymia res36: Bipolar disorder diagnostic Read
Eu34y00 [X]Other persistent mood affective disorders res36: Bipolar disorder diagnostic Read
Eu34z00 [X]Persistent mood affective disorder, unspecified res36: Bipolar disorder diagnostic Read
Eu3y.00 [X]Other mood affective disorders res36: Bipolar disorder diagnostic Read
Eu3y000 [X]Other single mood affective disorders res36: Bipolar disorder diagnostic Read
Eu3y011 [X]Mixed affective episode res36: Bipolar disorder diagnostic Read
Eu3y100 [X]Other recurrent mood affective disorders res36: Bipolar disorder diagnostic Read
Eu3yy00 [X]Other specified mood affective disorders res36: Bipolar disorder diagnostic Read
Eu3z.00 [X]Unspecified mood affective disorder res36: Bipolar disorder diagnostic Read
Eu3z.11 [X]Affective psychosis NOS res36: Bipolar disorder diagnostic Read
ZV11111 [V]Personal history of manic-depressive psychosis res36: Bipolar disorder diagnostic Read
ZV11112 [V]Personal history of manic-depressive psychosis res36: Bipolar disorder diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH369/version/738/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH369/version/738/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH369', '738', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH369/version/738/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH369/version/738/export/codes/?format=json
CSV site_root/phenotypes/PH369/version/738/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH369', '738', api_client=client)

Version History

Version
ID
Name Owner Publish date
738 Bipolar Disorder ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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