Background:
Little is known about the precursors of suicide risk among primary-care patients. This study aimed to examine suicide risk in relation to patterns of clinical consultation, psychotropic drug prescribing, and psychiatric diagnoses.
Method:
Nested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged516 years who died by suicide during 2002–2011 (N = 2384) were matched on gender, age and practice with up to 20 living control patients (N = 46 899).
Results:
Risk was raised among non-consulting patients, and increased sharply with rising number of consultations in the preceding year [512 consultations v. 1: unadjusted odds ratio (OR) 6.0, 95% confidence interval (CI) 4.9–7.3]. Markedly elevated risk was also associated with the prescribing of multiple psychotropic medication types (55 types v. 0: OR 62.6, CI 44.3–88.4) and with having several psychiatric diagnoses (54 diagnoses v. 0: OR 31.1, CI 19.3–50.1). Risk was also raised among patients living in more socially deprived localities. The confounding effect of multiple psychotropic drug types largely accounted for the rising risk gradient observed with increasing consultation frequency.
Conclusions:
A greater proportion of patients with several psychiatric diagnoses, those prescribed multiple psychotropic medication types, and those who consult at very high frequency might be considered for referral to mental health services by their general practitioners. Non-consulters are also at increased risk, which suggests that conventional models of primary care may not be effective in meeting the needs of all people in the community experiencing major psychosocial difficulties.
K Windfuhr, D While, N Kapur, D M Ashcroft, E Kontopantelis, M J Carr, J Shaw, L Appleby, R T Webb, Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary-care patients. Psychological Medicine, 46, 3407-3417, 2016.
Code | Description | Entity type | Category | Coding System (Read) |
---|---|---|---|---|
1B17.00 | Depressed | res38: Depression | diagnostic | Read |
2257.00 | O/E - depressed | res38: Depression | diagnostic | Read |
62T1.00 | Puerperal depression | res38: Depression | diagnostic | Read |
9kQ..00 | On full dose long term treatment depression - enh serv admin | res38: Depression | diagnostic | Read |
E001300 | Presenile dementia with depression | res38: Depression | diagnostic | Read |
E002100 | Senile dementia with depression | res38: Depression | diagnostic | Read |
E004300 | Arteriosclerotic dementia with depression | res38: Depression | diagnostic | Read |
E11..12 | Depressive psychoses | res38: Depression | diagnostic | Read |
E112.00 | Single major depressive episode | res38: Depression | diagnostic | Read |
E112.11 | Agitated depression | res38: Depression | diagnostic | Read |
E112.12 | Endogenous depression first episode | res38: Depression | diagnostic | Read |
E112.13 | Endogenous depression first episode | res38: Depression | diagnostic | Read |
E112.14 | Endogenous depression | res38: Depression | diagnostic | Read |
E112000 | Single major depressive episode, unspecified | res38: Depression | diagnostic | Read |
E112100 | Single major depressive episode, mild | res38: Depression | diagnostic | Read |
E112200 | Single major depressive episode, moderate | res38: Depression | diagnostic | Read |
E112300 | Single major depressive episode, severe, without psychosis | res38: Depression | diagnostic | Read |
E112400 | Single major depressive episode, severe, with psychosis | res38: Depression | diagnostic | Read |
E112z00 | Single major depressive episode NOS | res38: Depression | diagnostic | Read |
E113.00 | Recurrent major depressive episode | res38: Depression | diagnostic | Read |
E113.11 | Endogenous depression - recurrent | res38: Depression | diagnostic | Read |
E113000 | Recurrent major depressive episodes, unspecified | res38: Depression | diagnostic | Read |
E113100 | Recurrent major depressive episodes, mild | res38: Depression | diagnostic | Read |
E113200 | Recurrent major depressive episodes, moderate | res38: Depression | diagnostic | Read |
E113300 | Recurrent major depressive episodes, severe, no psychosis | res38: Depression | diagnostic | Read |
E113400 | Recurrent major depressive episodes, severe, with psychosis | res38: Depression | diagnostic | Read |
E113700 | Recurrent depression | res38: Depression | diagnostic | Read |
E113z00 | Recurrent major depressive episode NOS | res38: Depression | diagnostic | Read |
E118.00 | Seasonal affective disorder | res38: Depression | diagnostic | Read |
E11y200 | Atypical depressive disorder | res38: Depression | diagnostic | Read |
E11z200 | Masked depression | res38: Depression | diagnostic | Read |
E135.00 | Agitated depression | res38: Depression | diagnostic | Read |
E200300 | Anxiety with depression | res38: Depression | diagnostic | Read |
E204.00 | Neurotic depression reactive type | res38: Depression | diagnostic | Read |
E204.11 | Postnatal depression | res38: Depression | diagnostic | Read |
E290.00 | Brief depressive reaction | res38: Depression | diagnostic | Read |
E290z00 | Brief depressive reaction NOS | res38: Depression | diagnostic | Read |
E291.00 | Prolonged depressive reaction | res38: Depression | diagnostic | Read |
E2B..00 | Depressive disorder NEC | res38: Depression | diagnostic | Read |
E2B0.00 | Postviral depression | res38: Depression | diagnostic | Read |
E2B1.00 | Chronic depression | res38: Depression | diagnostic | Read |
Eu20400 | [X]Post-schizophrenic depression | res38: Depression | diagnostic | Read |
Eu32.00 | [X]Depressive episode | res38: Depression | diagnostic | Read |
Eu32.11 | [X]Single episode of depressive reaction | res38: Depression | diagnostic | Read |
Eu32.12 | [X]Single episode of psychogenic depression | res38: Depression | diagnostic | Read |
Eu32.13 | [X]Single episode of reactive depression | res38: Depression | diagnostic | Read |
Eu32000 | [X]Mild depressive episode | res38: Depression | diagnostic | Read |
Eu32100 | [X]Moderate depressive episode | res38: Depression | diagnostic | Read |
Eu32200 | [X]Severe depressive episode without psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32211 | [X]Single episode agitated depressn w'out psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32212 | [X]Single episode major depression w'out psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32213 | [X]Single episode vital depression w'out psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32300 | [X]Severe depressive episode with psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32311 | [X]Single episode of major depression and psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32312 | [X]Single episode of psychogenic depressive psychosis | res38: Depression | diagnostic | Read |
Eu32313 | [X]Single episode of psychotic depression | res38: Depression | diagnostic | Read |
Eu32314 | [X]Single episode of reactive depressive psychosis | res38: Depression | diagnostic | Read |
Eu32400 | [X]Mild depression | res38: Depression | diagnostic | Read |
Eu32500 | [X]Major depression, mild | res38: Depression | diagnostic | Read |
Eu32600 | [X]Major depression, moderately severe | res38: Depression | diagnostic | Read |
Eu32700 | [X]Major depression, severe without psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32800 | [X]Major depression, severe with psychotic symptoms | res38: Depression | diagnostic | Read |
Eu32900 | [X]Single major depr ep, severe with psych, psych in remiss | res38: Depression | diagnostic | Read |
Eu32A00 | [X]Recurr major depr ep, severe with psych, psych in remiss | res38: Depression | diagnostic | Read |
Eu32y00 | [X]Other depressive episodes | res38: Depression | diagnostic | Read |
Eu32y11 | [X]Atypical depression | res38: Depression | diagnostic | Read |
Eu32y12 | [X]Single episode of masked depression NOS | res38: Depression | diagnostic | Read |
Eu32z00 | [X]Depressive episode, unspecified | res38: Depression | diagnostic | Read |
Eu32z11 | [X]Depression NOS | res38: Depression | diagnostic | Read |
Eu32z12 | [X]Depressive disorder NOS | res38: Depression | diagnostic | Read |
Eu32z13 | [X]Prolonged single episode of reactive depression | res38: Depression | diagnostic | Read |
Eu32z14 | [X] Reactive depression NOS | res38: Depression | diagnostic | Read |
Eu33.00 | [X]Recurrent depressive disorder | res38: Depression | diagnostic | Read |
Eu33.11 | [X]Recurrent episodes of depressive reaction | res38: Depression | diagnostic | Read |
Eu33.12 | [X]Recurrent episodes of psychogenic depression | res38: Depression | diagnostic | Read |
Eu33.13 | [X]Recurrent episodes of reactive depression | res38: Depression | diagnostic | Read |
Eu33.14 | [X]Seasonal depressive disorder | res38: Depression | diagnostic | Read |
Eu33.15 | [X]SAD - Seasonal affective disorder | res38: Depression | diagnostic | Read |
Eu33000 | [X]Recurrent depressive disorder, current episode mild | res38: Depression | diagnostic | Read |
Eu33100 | [X]Recurrent depressive disorder, current episode moderate | res38: Depression | diagnostic | Read |
Eu33200 | [X]Recurr depress disorder cur epi severe without psyc sympt | res38: Depression | diagnostic | Read |
Eu33211 | [X]Endogenous depression without psychotic symptoms | res38: Depression | diagnostic | Read |
Eu33212 | [X]Major depression, recurrent without psychotic symptoms | res38: Depression | diagnostic | Read |
Eu33214 | [X]Vital depression, recurrent without psychotic symptoms | res38: Depression | diagnostic | Read |
Eu33300 | [X]Recurrent depress disorder cur epi severe with psyc symp | res38: Depression | diagnostic | Read |
Eu33311 | [X]Endogenous depression with psychotic symptoms | res38: Depression | diagnostic | Read |
Eu33312 | [X]Manic-depress psychosis,depressed type+psychotic symptoms | res38: Depression | diagnostic | Read |
Eu33313 | [X]Recurr severe episodes/major depression+psychotic symptom | res38: Depression | diagnostic | Read |
Eu33314 | [X]Recurr severe episodes/psychogenic depressive psychosis | res38: Depression | diagnostic | Read |
Eu33315 | [X]Recurrent severe episodes of psychotic depression | res38: Depression | diagnostic | Read |
Eu33316 | [X]Recurrent severe episodes/reactive depressive psychosis | res38: Depression | diagnostic | Read |
Eu33400 | [X]Recurrent depressive disorder, currently in remission | res38: Depression | diagnostic | Read |
Eu33y00 | [X]Other recurrent depressive disorders | res38: Depression | diagnostic | Read |
Eu33z00 | [X]Recurrent depressive disorder, unspecified | res38: Depression | diagnostic | Read |
Eu33z11 | [X]Monopolar depression NOS | res38: Depression | diagnostic | Read |
Eu34100 | [X]Dysthymia | res38: Depression | diagnostic | Read |
Eu34111 | [X]Depressive neurosis | res38: Depression | diagnostic | Read |
Eu34113 | [X]Neurotic depression | res38: Depression | diagnostic | Read |
Eu34114 | [X]Persistant anxiety depression | res38: Depression | diagnostic | Read |
Eu3y111 | [X]Recurrent brief depressive episodes | res38: Depression | diagnostic | Read |
Eu41200 | [X]Mixed anxiety and depressive disorder | res38: Depression | diagnostic | Read |
Eu41211 | [X]Mild anxiety depression | res38: Depression | diagnostic | Read |
Eu53011 | [X]Postnatal depression NOS | res38: Depression | diagnostic | Read |
Eu53012 | [X]Postpartum depression NOS | res38: Depression | diagnostic | Read |
Eu92000 | [X]Depressive conduct disorder | res38: Depression | diagnostic | Read |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH700/version/1400/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH700/version/1400/detail/?format=json |
R Package |
|
To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH700/version/1400/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH700/version/1400/export/codes/?format=json |
CSV | site_root/phenotypes/PH700/version/1400/export/codes/ |
R Package |
|
Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
1400 | Depression | ieuan.scanlon | 2021-10-06 | currently shown |
Export - export all codes into a csv file/JSON/XML for the current phenotype version.
Print - Print page.