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Bipolar Disorder

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Jonathan Green, Carolyn A Chew-Graham, Nav Kapur, Darren M Aschcroft

ID
PH584
Version ID
1168
Type
Disease or Syndrome
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
♀  Female ♂  Male
Agreement Date
2017-10-18
Coding system
Read codes v2
Collections
ClinicalCodes Repository Phenotype Library
Tags
No tags

Definition

Objectives:

To examine temporal trends in sex and age specific incidence of self harm in children and adolescents, clinical management patterns, and risk of cause specific mortality following an index self harm episode at a young age.

Design:

Population based cohort study.

Setting:

UK Clinical Practice Research Datalink—electronic health records from 674 general practices, with practice level deprivation measured ecologically using the index of multiple deprivation. Patients from eligible English practices were linked to hospital episode statistics (HES) and Office for National Statistics (ONS) mortality records.

Participants:

For the descriptive analytical phases we examined data pertaining to 16 912 patients aged 10-19 who harmed themselves during 2001-14. For analysis of cause specific mortality following self harm, 8638 patients eligible for HES and ONS linkage were matched by age, sex, and general practice with up to 20 unaffected children and adolescents (n=170 274).

Main outcome measures:

In the first phase, temporal trends in sex and age specific annual incidence were examined. In the second phase, clinical management was assessed according to the likelihood of referral to mental health services and psychotropic drug prescribing. In the third phase, relative risks of all cause mortality, unnatural death (including suicide and accidental death), and fatal acute alcohol or drug poisoning were estimated as hazard ratios derived from stratified Cox proportional hazards models for the self harm cohort versus the matched unaffected comparison cohort.

Results:

The annual incidence of self harm was observed to increase in girls (37.4 per 10 000) compared with boys (12.3 per 10 000), and a sharp 68% increase occurred among girls aged 13-16, from 45.9 per 10 000 in 2011 to 77.0 per 10 000 in 2014. Referrals within 12 months of the index self harm episode were 23% less likely for young patients registered at the most socially deprived practices, even though incidences were considerably higher in these localities. Children and adolescents who harmed themselves were approximately nine times more likely to die unnaturally during follow-up, with especially noticeable increases in risks of suicide (deprivation adjusted hazard ratio 17.5, 95% confidence interval 7.6 to 40.5) and fatal acute alcohol or drug poisoning (34.3, 10.2 to 115.7).

Conclusions:

Gaining a better understanding of the mechanisms responsible for the recent apparent increase in the incidence of self harm among early-mid teenage girls, and coordinated initiatives to tackle health inequalities in the provision of services to distressed children and adolescents, represent urgent priorities for multiple public agencies.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Jonathan Green, Carolyn A Chew-Graham, Nav Kapur, Darren M Aschcroft, Incidence, clinical management, and mortality risk following self harm among children and adolescents cohort study in primary care. BMJ, 359(j4351), 2017.

Clinical Code List

Rows: 102
Code Description Entity type Category Coding System (Read)
1S42.00 manic mood res59: Bipolar_disorder diagnostic Read
212V.00 bipolar affective disorder resolved res59: Bipolar_disorder diagnostic Read
E11..00 Affective psychoses res59: Bipolar_disorder diagnostic Read
E11..11 bipolar psychoses res59: Bipolar_disorder diagnostic Read
E11..13 manic psychoses res59: Bipolar_disorder diagnostic Read
E110.00 manic disorder, single episode res59: Bipolar_disorder diagnostic Read
E110.11 hypomanic psychoses res59: Bipolar_disorder diagnostic Read
E110000 single manic episode, unspecified res59: Bipolar_disorder diagnostic Read
E110100 single manic episode, mild res59: Bipolar_disorder diagnostic Read
E110200 single manic episode, moderate res59: Bipolar_disorder diagnostic Read
E110300 single manic episode, severe without mention of psychosis res59: Bipolar_disorder diagnostic Read
E110400 single manic episode, severe, with psychosis res59: Bipolar_disorder diagnostic Read
E110600 single manic episode in full remission res59: Bipolar_disorder diagnostic Read
E110z00 manic disorder, single episode nos res59: Bipolar_disorder diagnostic Read
E111.00 recurrent manic episodes res59: Bipolar_disorder diagnostic Read
E111000 recurrent manic episodes, unspecified res59: Bipolar_disorder diagnostic Read
E111100 recurrent manic episodes, mild res59: Bipolar_disorder diagnostic Read
E111200 recurrent manic episodes, moderate res59: Bipolar_disorder diagnostic Read
E111300 recurrent manic episodes, severe without mention psychosis res59: Bipolar_disorder diagnostic Read
E111400 recurrent manic episodes, severe, with psychosis res59: Bipolar_disorder diagnostic Read
E111500 recurrent manic episodes, partial or unspecified remission res59: Bipolar_disorder diagnostic Read
E111600 recurrent manic episodes, in full remission res59: Bipolar_disorder diagnostic Read
E111z00 recurrent manic episode nos res59: Bipolar_disorder diagnostic Read
E114.00 bipolar affective disorder, currently manic res59: Bipolar_disorder diagnostic Read
E114.11 manic-depressive - now manic res59: Bipolar_disorder diagnostic Read
E114000 bipolar affective disorder, currently manic, unspecified res59: Bipolar_disorder diagnostic Read
E114100 bipolar affective disorder, currently manic, mild res59: Bipolar_disorder diagnostic Read
E114200 bipolar affective disorder, currently manic, moderate res59: Bipolar_disorder diagnostic Read
E114300 bipolar affect disord, currently manic, severe, no psychosis res59: Bipolar_disorder diagnostic Read
E114400 bipolar affect disord, currently manic,severe with psychosis res59: Bipolar_disorder diagnostic Read
E114500 bipolar affect disord,currently manic, part/unspec remission res59: Bipolar_disorder diagnostic Read
E114600 bipolar affective disorder, currently manic, full remission res59: Bipolar_disorder diagnostic Read
E114z00 bipolar affective disorder, currently manic, nos res59: Bipolar_disorder diagnostic Read
E115.00 bipolar affective disorder, currently depressed res59: Bipolar_disorder diagnostic Read
E115.11 manic-depressive - now depressed res59: Bipolar_disorder diagnostic Read
E115000 bipolar affective disorder, currently depressed, unspecified res59: Bipolar_disorder diagnostic Read
E115100 bipolar affective disorder, currently depressed, mild res59: Bipolar_disorder diagnostic Read
E115200 bipolar affective disorder, currently depressed, moderate res59: Bipolar_disorder diagnostic Read
E115300 bipolar affect disord, now depressed, severe, no psychosis res59: Bipolar_disorder diagnostic Read
E115400 bipolar affect disord, now depressed, severe with psychosis res59: Bipolar_disorder diagnostic Read
E115500 bipolar affect disord, now depressed, part/unspec remission res59: Bipolar_disorder diagnostic Read
E115600 bipolar affective disorder, now depressed, in full remission res59: Bipolar_disorder diagnostic Read
E115z00 bipolar affective disorder, currently depressed, nos res59: Bipolar_disorder diagnostic Read
E116.00 mixed bipolar affective disorder res59: Bipolar_disorder diagnostic Read
E116000 mixed bipolar affective disorder, unspecified res59: Bipolar_disorder diagnostic Read
E116100 mixed bipolar affective disorder, mild res59: Bipolar_disorder diagnostic Read
E116200 mixed bipolar affective disorder, moderate res59: Bipolar_disorder diagnostic Read
E116300 mixed bipolar affective disorder, severe, without psychosis res59: Bipolar_disorder diagnostic Read
E116400 mixed bipolar affective disorder, severe, with psychosis res59: Bipolar_disorder diagnostic Read
E116500 mixed bipolar affective disorder, partial/unspec remission res59: Bipolar_disorder diagnostic Read
E116600 mixed bipolar affective disorder, in full remission res59: Bipolar_disorder diagnostic Read
E116z00 mixed bipolar affective disorder, nos res59: Bipolar_disorder diagnostic Read
E117.00 unspecified bipolar affective disorder res59: Bipolar_disorder diagnostic Read
E117000 unspecified bipolar affective disorder, unspecified res59: Bipolar_disorder diagnostic Read
E117100 unspecified bipolar affective disorder, mild res59: Bipolar_disorder diagnostic Read
E117200 unspecified bipolar affective disorder, moderate res59: Bipolar_disorder diagnostic Read
E117300 unspecified bipolar affective disorder, severe, no psychosis res59: Bipolar_disorder diagnostic Read
E117400 unspecified bipolar affective disorder,severe with psychosis res59: Bipolar_disorder diagnostic Read
E117500 unspecified bipolar affect disord, partial/unspec remission res59: Bipolar_disorder diagnostic Read
E117600 unspecified bipolar affective disorder, in full remission res59: Bipolar_disorder diagnostic Read
E117z00 unspecified bipolar affective disorder, nos res59: Bipolar_disorder diagnostic Read
E11y.00 other and unspecified manic-depressive psychoses res59: Bipolar_disorder diagnostic Read
E11y000 unspecified manic-depressive psychoses res59: Bipolar_disorder diagnostic Read
E11y100 atypical manic disorder res59: Bipolar_disorder diagnostic Read
E11y300 other mixed manic-depressive psychoses res59: Bipolar_disorder diagnostic Read
E11yz00 other and unspecified manic-depressive psychoses nos res59: Bipolar_disorder diagnostic Read
Eu3..00 [X]Mood - affective disorders res59: Bipolar_disorder diagnostic Read
Eu30.00 [x]manic episode res59: Bipolar_disorder diagnostic Read
Eu30.11 [x]bipolar disorder, single manic episode res59: Bipolar_disorder diagnostic Read
Eu30000 [x]hypomania res59: Bipolar_disorder diagnostic Read
Eu30100 [x]mania without psychotic symptoms res59: Bipolar_disorder diagnostic Read
Eu30200 [x]mania with psychotic symptoms res59: Bipolar_disorder diagnostic Read
Eu30211 [x]mania with mood-congruent psychotic symptoms res59: Bipolar_disorder diagnostic Read
Eu30212 [x]mania with mood-incongruent psychotic symptoms res59: Bipolar_disorder diagnostic Read
Eu30y00 [x]other manic episodes res59: Bipolar_disorder diagnostic Read
Eu30z00 [x]manic episode, unspecified res59: Bipolar_disorder diagnostic Read
Eu30z11 [x]mania nos res59: Bipolar_disorder diagnostic Read
Eu31.00 [x]bipolar affective disorder res59: Bipolar_disorder diagnostic Read
Eu31.11 [x]manic-depressive illness res59: Bipolar_disorder diagnostic Read
Eu31.12 [x]manic-depressive psychosis res59: Bipolar_disorder diagnostic Read
Eu31.13 [x]manic-depressive reaction res59: Bipolar_disorder diagnostic Read
Eu31000 [x]bipolar affective disorder, current episode hypomanic res59: Bipolar_disorder diagnostic Read
Eu31100 [x]bipolar affect disorder cur epi manic wout psychotic symp res59: Bipolar_disorder diagnostic Read
Eu31200 [x]bipolar affect disorder cur epi manic with psychotic symp res59: Bipolar_disorder diagnostic Read
Eu31300 [x]bipolar affect disorder cur epi mild or moderate depressn res59: Bipolar_disorder diagnostic Read
Eu31400 [x]bipol aff disord, curr epis sev depress, no psychot symp res59: Bipolar_disorder diagnostic Read
Eu31500 [x]bipolar affect dis cur epi severe depres with psyc symp res59: Bipolar_disorder diagnostic Read
Eu31600 [x]bipolar affective disorder, current episode mixed res59: Bipolar_disorder diagnostic Read
Eu31700 [x]bipolar affective disorder, currently in remission res59: Bipolar_disorder diagnostic Read
Eu31800 [x]bipolar affective disorder type i res59: Bipolar_disorder diagnostic Read
Eu31900 [x]bipolar affective disorder type ii res59: Bipolar_disorder diagnostic Read
Eu31911 [x]bipolar ii disorder res59: Bipolar_disorder diagnostic Read
Eu31y00 [x]other bipolar affective disorders res59: Bipolar_disorder diagnostic Read
Eu31y11 [x]bipolar ii disorder res59: Bipolar_disorder diagnostic Read
Eu31y12 [x]recurrent manic episodes res59: Bipolar_disorder diagnostic Read
Eu31z00 [x]bipolar affective disorder, unspecified res59: Bipolar_disorder diagnostic Read
Eu34.00 [X]Persistent mood affective disorders res59: Bipolar_disorder diagnostic Read
Eu34y00 [X]Other persistent mood affective disorders res59: Bipolar_disorder diagnostic Read
Eu34z00 [X]Persistent mood affective disorder, unspecified res59: Bipolar_disorder diagnostic Read
Eu3y011 [X]Mixed affective episode res59: Bipolar_disorder diagnostic Read
Eu3y100 [X]Other recurrent mood affective disorders res59: Bipolar_disorder diagnostic Read
Eu3z.11 [X]Affective psychosis NOS res59: Bipolar_disorder diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH584/version/1168/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH584/version/1168/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('PH584', '1168', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH584/version/1168/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH584/version/1168/export/codes/?format=json
CSV site_root/phenotypes/PH584/version/1168/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('PH584', '1168', api_client=client)

Version History

Version
ID
Name Owner Publish date
1168 Bipolar Disorder ieuan.scanlon 2021-10-06 currently shown

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