Lithium and other mood stabilisers
K Windfuhr, D While, N Kapur, D M Ashcroft, E Kontopantelis, M J Carr, J Shaw, L Applyby, R T Webb
PH702 / 1404 Clinical-Coded Phenotype
Overview
Phenotype TypeDrugSexBothValid Event Date Range01/01/2002 - 31/12/2011Coding SystemMultilex codesData SourcesCollectionsClinicalCodes RepositoryPhenotype LibraryTagsNo dataDefinition
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.
Implementation
No dataImplementation
Clinical Code List
PUBLISHED - 207 Codes
Publication
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.
No dataCitation Requirements
API
To Export Phenotype Details:
Format API JSON site_root/api/v1/phenotypes/PH702/version/1404/detail/?format=json R Package library(ConceptLibraryClient)
# Connect to API
client = ConceptLibraryClient::Connection$new(public=TRUE)
# Get details of phenotype
phenotype_details = client$phenotypes$get_detail(
'PH702',
version_id=1404
)Py Package from pyconceptlibraryclient import Client
# Connect to API
client = Client(public=True)
# Get codelist of phenotype
phenotype_codelist = client.phenotypes.get_detail(
'PH702',
version_id=1404
)To Export Phenotype Code List:
Format API JSON site_root/api/v1/phenotypes/PH702/version/1404/export/codes/?format=json CSV site_root/phenotypes/PH702/version/1404/export/codes/ R Package library(ConceptLibraryClient)
# Connect to API
client = ConceptLibraryClient::Connection$new(public=TRUE)
# Get codelist of phenotype
phenotype_codelist = client$phenotypes$get_codelist(
'PH702',
version_id=1404
)Py Package from pyconceptlibraryclient import Client
# Connect to API
client = Client(public=True)
# Get codelist of phenotype
phenotype_codelist = client.phenotypes.get_codelist(
'PH702',
version_id=1404
)Version History