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Eating 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
PH587
Version ID
1174
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: 41
Code Description Entity type Category Coding System (Read)
1612.00 Appetite loss - anorexia res59: Eating_disorder diagnostic Read
1612.11 Anorexia symptom res59: Eating_disorder diagnostic Read
1614.00 Excessive eating - polyphagia res59: Eating_disorder diagnostic Read
1614.11 Hyperalimentation - symptom res59: Eating_disorder diagnostic Read
1614.12 Polyphagia symptom res59: Eating_disorder diagnostic Read
8HTN.00 Referral to eating disorders clinic res59: Eating_disorder diagnostic Read
9Nk9.00 Seen in eating disorder clinic res59: Eating_disorder diagnostic Read
E271.00 Anorexia nervosa res59: Eating_disorder diagnostic Read
E275.00 Other and unspecified non-organic eating disorders res59: Eating_disorder diagnostic Read
E275000 Unspecified non-organic eating disorder res59: Eating_disorder diagnostic Read
E275100 Bulimia (non-organic overeating) res59: Eating_disorder diagnostic Read
E275111 Compulsive eating disorder res59: Eating_disorder diagnostic Read
E275300 Psychogenic rumination res59: Eating_disorder diagnostic Read
E275400 Psychogenic vomiting NOS res59: Eating_disorder diagnostic Read
E275y00 Other specified non-organic eating disorder res59: Eating_disorder diagnostic Read
E275z00 Non-organic eating disorder NOS res59: Eating_disorder diagnostic Read
Eu50.00 [X]Eating disorders res59: Eating_disorder diagnostic Read
Eu50000 [X]Anorexia nervosa res59: Eating_disorder diagnostic Read
Eu50100 [X]Atypical anorexia nervosa res59: Eating_disorder diagnostic Read
Eu50200 [X]Bulimia nervosa res59: Eating_disorder diagnostic Read
Eu50211 [X]Bulimia NOS res59: Eating_disorder diagnostic Read
Eu50212 [X]Hyperorexia nervosa res59: Eating_disorder diagnostic Read
Eu50300 [X]Atypical bulimia nervosa res59: Eating_disorder diagnostic Read
Eu50400 [X]Overeating associated with other psychological disturbncs res59: Eating_disorder diagnostic Read
Eu50411 [X]Psychogenic overeating res59: Eating_disorder diagnostic Read
Eu50500 [X]Vomiting associated with other psychological disturbances res59: Eating_disorder diagnostic Read
Eu50511 [X]Psychogenic vomiting res59: Eating_disorder diagnostic Read
Eu50y00 [X]Other eating disorders res59: Eating_disorder diagnostic Read
Eu50z00 [X]Eating disorder; unspecified res59: Eating_disorder diagnostic Read
Fy05.00 Nocturnal sleep-related eating disorder res59: Eating_disorder diagnostic Read
R030.00 [D]Anorexia res59: Eating_disorder diagnostic Read
R030z00 [D]Anorexia NOS res59: Eating_disorder diagnostic Read
R036.00 [D]Polyphagia res59: Eating_disorder diagnostic Read
R036000 [D]Excessive eating res59: Eating_disorder diagnostic Read
R036011 [D]Bulimia NOS res59: Eating_disorder diagnostic Read
R036100 [D]Hyperalimentation res59: Eating_disorder diagnostic Read
R036z00 [D]Polyphagia NOS res59: Eating_disorder diagnostic Read
SN42100 Starvation res59: Eating_disorder diagnostic Read
U1B3.11 [X]Starvation res59: Eating_disorder diagnostic Read
Z4B5.00 Eating disorder counselling res59: Eating_disorder diagnostic Read
ZC2CD00 Dietary advice for eating disorder res59: Eating_disorder diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH587/version/1174/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH587/version/1174/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('PH587', '1174', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH587/version/1174/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH587/version/1174/export/codes/?format=json
CSV site_root/phenotypes/PH587/version/1174/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('PH587', '1174', api_client=client)

Version History

Version
ID
Name Owner Publish date
1174 Eating Disorder ieuan.scanlon 2021-10-06 currently shown

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