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Extra Referral Codes

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
PH588
Version ID
1176
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: 33
Code Description Entity type Category Coding System (Read)
64R7.11 Child refer- clinical psychol. res59: Extra_referral_codes diagnostic Read
8H23.00 Admit psychiatric emergency res59: Extra_referral_codes diagnostic Read
8H23000 Emerg psychiatric admiss MHA res59: Extra_referral_codes diagnostic Read
8H49.00 Psychiatric referral res59: Extra_referral_codes diagnostic Read
8H4P.00 Referral to child psychiatrist res59: Extra_referral_codes diagnostic Read
8H4f.00 Referral to learning disabilities psychiatrist res59: Extra_referral_codes diagnostic Read
8H7T.00 Refer to psychologist res59: Extra_referral_codes diagnostic Read
8HHR.00 Referral to child and adolescent psychiatry service res59: Extra_referral_codes diagnostic Read
8HHT.00 Referral to psychotherapist res59: Extra_referral_codes diagnostic Read
8HHs.00 Referral to psychosis early intervention service res59: Extra_referral_codes diagnostic Read
8HHu.00 Referral to primary care mental health gateway worker res59: Extra_referral_codes diagnostic Read
8HHv.00 Referral to primary care mental health graduate worker res59: Extra_referral_codes diagnostic Read
8HJ3.00 Psychiatric self-referral res59: Extra_referral_codes diagnostic Read
8HVO.00 Private referral to psychiatrist res59: Extra_referral_codes diagnostic Read
8HVi.00 Private referral to psychologist res59: Extra_referral_codes diagnostic Read
8Hc..00 Referral to mental health team res59: Extra_referral_codes diagnostic Read
8Hc0.00 Referral to community mental health team res59: Extra_referral_codes diagnostic Read
8Hc2.00 Referral to primary care mental health team res59: Extra_referral_codes diagnostic Read
8HlB.00 Urgent referral to psychiatrist res59: Extra_referral_codes diagnostic Read
8HlD.00 Referral to forensic psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B.00 Referral to psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B100 Referral to child and adolescent psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B111 Referral to child psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B200 Referral to forensic psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B300 Referral to liaison psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B400 Referral to rehabilitation psychiatrist res59: Extra_referral_codes diagnostic Read
ZL5B500 Referral to psychiatrist for mental handicap res59: Extra_referral_codes diagnostic Read
ZL62A00 Referral to nurse behavioural therapist res59: Extra_referral_codes diagnostic Read
ZL62B00 Referral to nurse psychotherapist res59: Extra_referral_codes diagnostic Read
ZL62E00 Referral to psychiatric nurse res59: Extra_referral_codes diagnostic Read
ZL77.00 Referral to psychotherapist res59: Extra_referral_codes diagnostic Read
ZL78.00 Referral to psychologist res59: Extra_referral_codes diagnostic Read
ZL78.11 Refer to psychologist res59: Extra_referral_codes diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH588/version/1176/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH588/version/1176/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('PH588', '1176', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH588/version/1176/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH588/version/1176/export/codes/?format=json
CSV site_root/phenotypes/PH588/version/1176/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('PH588', '1176', api_client=client)

Version History

Version
ID
Name Owner Publish date
1176 Extra Referral Codes ieuan.scanlon 2021-10-06 currently shown

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