PURPOSE:
Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves.
METHODS:
During 2001-2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm. We estimated the relative risks of all-cause and cause-specific natural and unnatural mortality using a comparison cohort of 600,258 individuals matched on age, sex, and general practice.
RESULTS:
We found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio for that year, 3.6; 95% CI, 3.1-4.2). In particular, suicide risk was especially high during the first year (adjusted hazard ratio, 54.4; 95% CI, 34.3-86.3); although it declined sharply, it remained much higher than that in the comparison cohort. Large elevations of risk throughout the follow-up period were also observed for accidental, alcohol-related, and drug poisoning deaths. At 10 years of follow-up, cumulative incidence values were 6.5% (95% CI, 6.0%-7.1%) for allcause mortality and 1.3% (95% CI, 1.2%-1.5%) for suicide.
CONCLUSIONS:
Primary care patients who have harmed themselves are at greatly increased risk of dying prematurely by natural and unnatural causes, and especially within a year of a first episode. These individuals visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. Primary care patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require concerted, multipronged, multidisciplinary collaborative care approaches.
Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb, Premature Death Among Primary Care Patients With a History of Self-Harm. Annals of Family Medicine, 15(3), 2017.
Code | Description | Entity type | Category | Coding System (Read) |
---|---|---|---|---|
E21..00 | Personality disorders | res41: Personality disorder | diagnostic | Read |
E21..11 | Neurotic personality disorder | res41: Personality disorder | diagnostic | Read |
E210.00 | Paranoid personality disorder | res41: Personality disorder | diagnostic | Read |
E211.00 | Affective personality disorder | res41: Personality disorder | diagnostic | Read |
E211000 | Unspecified affective personality disorder | res41: Personality disorder | diagnostic | Read |
E211100 | Hypomanic personality disorder | res41: Personality disorder | diagnostic | Read |
E211200 | Depressive personality disorder | res41: Personality disorder | diagnostic | Read |
E211300 | Cyclothymic personality disorder | res41: Personality disorder | diagnostic | Read |
E211z00 | Affective personality disorder NOS | res41: Personality disorder | diagnostic | Read |
E212.00 | Schizoid personality disorder | res41: Personality disorder | diagnostic | Read |
E212000 | Unspecified schizoid personality disorder | res41: Personality disorder | diagnostic | Read |
E212z00 | Schizoid personality disorder NOS | res41: Personality disorder | diagnostic | Read |
E213.00 | Explosive personality disorder | res41: Personality disorder | diagnostic | Read |
E214.00 | Compulsive personality disorders | res41: Personality disorder | diagnostic | Read |
E214.11 | Anancastic personality | res41: Personality disorder | diagnostic | Read |
E214000 | Anankastic personality | res41: Personality disorder | diagnostic | Read |
E214z00 | Compulsive personality disorder NOS | res41: Personality disorder | diagnostic | Read |
E215.00 | Histrionic personality disorders | res41: Personality disorder | diagnostic | Read |
E215.11 | Hysterical personality disorders | res41: Personality disorder | diagnostic | Read |
E215000 | Unspecified histrionic personality disorder | res41: Personality disorder | diagnostic | Read |
E215z00 | Histrionic personality disorder NOS | res41: Personality disorder | diagnostic | Read |
E216.00 | Inadequate personality disorder | res41: Personality disorder | diagnostic | Read |
E217.00 | Antisocial or sociopathic personality disorder | res41: Personality disorder | diagnostic | Read |
E21y.00 | Other personality disorders | res41: Personality disorder | diagnostic | Read |
E21y000 | Narcissistic personality disorder | res41: Personality disorder | diagnostic | Read |
E21y100 | Avoidant personality disorder | res41: Personality disorder | diagnostic | Read |
E21y200 | Borderline personality disorder | res41: Personality disorder | diagnostic | Read |
E21y300 | Passive-aggressive personality disorder | res41: Personality disorder | diagnostic | Read |
E21y400 | Eccentric personality disorder | res41: Personality disorder | diagnostic | Read |
E21y500 | Immature personality disorder | res41: Personality disorder | diagnostic | Read |
E21y600 | Masochistic personality disorder | res41: Personality disorder | diagnostic | Read |
E21y700 | Psychoneurotic personality disorder | res41: Personality disorder | diagnostic | Read |
E21yz00 | Other personality disorder NOS | res41: Personality disorder | diagnostic | Read |
E21z.00 | Personality disorder NOS | res41: Personality disorder | diagnostic | Read |
E21z.11 | Psychopathic personality | res41: Personality disorder | diagnostic | Read |
Eu06000 | [X]Organic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu06011 | [X]Organic pseudopsychopathic personality | res41: Personality disorder | diagnostic | Read |
Eu21.17 | [X]Pseudopsychopathic schizophrenia | res41: Personality disorder | diagnostic | Read |
Eu21.18 | [X]Schizotypal personality disorder | res41: Personality disorder | diagnostic | Read |
Eu34011 | [X]Affective personality disorder | res41: Personality disorder | diagnostic | Read |
Eu34112 | [X]Depressive personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60.00 | [X]Specific personality disorders | res41: Personality disorder | diagnostic | Read |
Eu60000 | [X]Paranoid personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60013 | [X]Querulant personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60014 | [X]Sensitive paranoid personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60100 | [X]Schizoid personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60200 | [X]Dissocial personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60212 | [X]Antisocial personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60213 | [X]Asocial personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60214 | [X]Psychopathic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60215 | [X]Sociopathic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60300 | [X]Emotionally unstable personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60311 | [X]Aggressive personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60312 | [X]Borderline personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60313 | [X]Explosive personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60400 | [X]Histrionic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60411 | [X]Hysterical personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60412 | [X]Psychoinfantile personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60500 | [X]Anankastic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60511 | [X]Compulsive personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60512 | [X]Obsessional personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60513 | [X]Obsessive-compulsive personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60600 | [X]Anxious [avoidant] personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60700 | [X]Dependent personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60711 | [X]Asthenic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60712 | [X]Inadequate personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60713 | [X]Passive personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60714 | [X]Self defeating personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60y00 | [X]Other specific personality disorders | res41: Personality disorder | diagnostic | Read |
Eu60y11 | [X]Eccentric personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60y12 | [X]Haltlose type personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60y13 | [X]Immature personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60y14 | [X]Narcissistic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60y16 | [X]Psychoneurotic personality disorder | res41: Personality disorder | diagnostic | Read |
Eu60z00 | [X]Personality disorder, unspecified | res41: Personality disorder | diagnostic | Read |
Eu61.00 | [X]Mixed and other personality disorders | res41: Personality disorder | diagnostic | Read |
Eu84511 | [X]Autistic psychopathy | res41: Personality disorder | diagnostic | Read |
Eu94211 | [X]Affectionless psychopathy | res41: Personality disorder | diagnostic | Read |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH385/version/770/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH385/version/770/detail/?format=json |
R Package |
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To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH385/version/770/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH385/version/770/export/codes/?format=json |
CSV | site_root/phenotypes/PH385/version/770/export/codes/ |
R Package |
|
Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
770 | Personality 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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