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Conduct Disorder

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

Type
Disease or Syndrome
ID
PH585
Version ID
1170
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
Tags /Collections
ClinicalCodes Repository Phenotype Library

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: 34
Code Description Entity type Category Coding System (Read)
E284.00 stress reaction causing mixed disturbance of emotion/conduct res59: Conduct_disorder diagnostic Read
E2C..00 disturbance of conduct nec res59: Conduct_disorder diagnostic Read
E2C0.00 aggressive unsocial conduct disorder res59: Conduct_disorder diagnostic Read
E2C0z00 aggressive unsocial conduct disorder nos res59: Conduct_disorder diagnostic Read
E2C1.00 nonaggressive unsocial conduct disorder res59: Conduct_disorder diagnostic Read
E2C1z00 nonaggressive unsocial conduct disorder nos res59: Conduct_disorder diagnostic Read
E2C2.00 socialised conduct disorder res59: Conduct_disorder diagnostic Read
E2C2z00 socialised conduct disorder nos res59: Conduct_disorder diagnostic Read
E2C4.00 mixed disturbance of conduct and emotion res59: Conduct_disorder diagnostic Read
E2C4z00 mixed disturbance of conduct and emotion nos res59: Conduct_disorder diagnostic Read
E2Cy.00 other conduct disturbances res59: Conduct_disorder diagnostic Read
E2Cyz00 other conduct disturbances nos res59: Conduct_disorder diagnostic Read
E2Cz.00 unspecified disturbance of conduct res59: Conduct_disorder diagnostic Read
E2Czz00 disturbance of conduct nos res59: Conduct_disorder diagnostic Read
E2Dy000 childhood and adolescent oppositional disorder res59: Conduct_disorder diagnostic Read
E2E2.00 Hyperkinetic conduct disorder res59: Conduct_disorder diagnostic Read
Eu90100 [X]Hyperkinetic conduct disorder res59: Conduct_disorder diagnostic Read
Eu90111 [X]Hyperkinetic disorder associated with conduct disorder res59: Conduct_disorder diagnostic Read
Eu91.00 [x]conduct disorders res59: Conduct_disorder diagnostic Read
Eu91000 [x]conduct disorder confined to the family context res59: Conduct_disorder diagnostic Read
Eu91100 [x]unsocialized conduct disorder res59: Conduct_disorder diagnostic Read
Eu91111 [x]conduct disorder, solitary aggressive type res59: Conduct_disorder diagnostic Read
Eu91200 [x]socialized conduct disorder res59: Conduct_disorder diagnostic Read
Eu91300 [X]Oppositional defiant disorder res59: Conduct_disorder diagnostic Read
Eu91y00 [x]other conduct disorders res59: Conduct_disorder diagnostic Read
Eu91z00 [x]conduct disorder, unspecified res59: Conduct_disorder diagnostic Read
Eu91z11 [X]Childhood behavioural disorder NOS res59: Conduct_disorder diagnostic Read
Eu91z12 [x]childhood conduct disorder nos res59: Conduct_disorder diagnostic Read
Eu92.00 [x]mixed disorders of conduct and emotions res59: Conduct_disorder diagnostic Read
Eu92000 [x]depressive conduct disorder res59: Conduct_disorder diagnostic Read
Eu92y00 [x]other mixed disorders of conduct and emotions res59: Conduct_disorder diagnostic Read
Eu92y11 [x]conduct disorder associated with emotional disorder res59: Conduct_disorder diagnostic Read
Eu92y12 [x]conduct disorder associated with neurotic disorder res59: Conduct_disorder diagnostic Read
Eu92z00 [x]mixed disorder of conduct and emotions, unspecified res59: Conduct_disorder diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH585/version/1170/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH585/version/1170/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('PH585', '1170', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH585/version/1170/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH585/version/1170/export/codes/?format=json
CSV site_root/phenotypes/PH585/version/1170/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('PH585', '1170', api_client=client)

Version History

Version
ID
Name Owner Publish date
1170 Conduct Disorder ieuan.scanlon 2021-10-06 currently shown

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