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Anxiety

Matthew J Carr, Sarah Steeg, Roger T Webb, Nav Kapur, Carolyn A Chew-Graham, Kathryn M Abel, Holly Hope, Matthias Pierce, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH829
Version ID
1737
Data Sources
Valid event data range
01/01/2010 - 30/06/2020
Sex
Female, Male
Agreement Date
2020-10-08
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

The Covid-19 pandemic has adversely affected population mental health.

Methods:

Using electronic health records from 1714 UK general practices registered with the Clinical Practice Research Datalink we examined incidence and event rates of depression and anxiety disorders, self-harm, prescriptions for antidepressants and benzodiazepines and GP referrals to mental health services per 100,000 person-months, before, during and after the peak of the Covid-19 emergency. Analyses were stratified by gender, age group and practice-level Index of Multiple Deprivation quintile.

Findings:

In April 2020, primary care-recorded incident depression reduced by 43·6% (95% CI 39·0% to 47·9%), anxiety disorders by 48·2% (CI 44·6% to 51·5%) and antidepressant prescribing by 36·2% (CI 33·7% to 38·6%) compared to expected rates based on prior trends. Reductions in first diagnoses of depression and anxiety disorders were particularly stark for working-age adults and patients registered at practices in more deprived areas. Self-harm incidence was 38·5% (CI 35·7% to 41·3%) lower than expected in April 2020. Total self-harm contacts fell by 28·2% (CI 25·5% to 30·8%). Rates of both incident and any self-harm remained around thirty percent lower than expected up to June 2020.

Interpretation:

Our findings reveal a stark treatment gap that was greater for first diagnoses of depression and anxiety disorders in working age adults, for practice populations in deprived areas, and for self-harm. Consequences could include more patients subsequently presenting with greater acuity and severity of mental illness and rising rates of non-fatal self-harm and suicide.

Publications

  • Matthew J Carr, Sarah Steeg, Roger T Webb, Nav Kapur, Carolyn A Chew-Graham, Kathryn M Abel, Holly Hope, Matthias Pierce, Darren M. Ashcroft, Primary care contact for mental illness and self-harm before during and after the peak of the Covid-19 pandemic in the UK cohort study of 13 million individual. PrePrint not peer reviewed, 2020.

Clinical Code List

Rows: 88
Code Description Entity type Category Coding System (Read)
1B1V.00 C/O - panic attack res173: Anxiety (Read codes) diagnostic Read
225J.00 O/E - panic attack res173: Anxiety (Read codes) diagnostic Read
8CAZ000 Patient given advice about management of anxiety res173: Anxiety (Read codes) diagnostic Read
8G52.00 Antiphobic therapy res173: Anxiety (Read codes) diagnostic Read
8G94.00 Anxiety management training res173: Anxiety (Read codes) diagnostic Read
8HHp.00 Referral for guided self-help for anxiety res173: Anxiety (Read codes) diagnostic Read
8IH5300 Referral for guided self-help for anxiety declined res173: Anxiety (Read codes) diagnostic Read
E200100 Panic disorder res173: Anxiety (Read codes) diagnostic Read
E200111 Panic attack res173: Anxiety (Read codes) diagnostic Read
E200200 Generalised anxiety disorder res173: Anxiety (Read codes) diagnostic Read
E200300 Anxiety with depression res173: Anxiety (Read codes) diagnostic Read
E200400 Chronic anxiety res173: Anxiety (Read codes) diagnostic Read
E200500 Recurrent anxiety res173: Anxiety (Read codes) diagnostic Read
E202.00 Phobic disorders res173: Anxiety (Read codes) diagnostic Read
E202.11 Social phobic disorders res173: Anxiety (Read codes) diagnostic Read
E202.12 Phobic anxiety res173: Anxiety (Read codes) diagnostic Read
E202.99 Phobic state res173: Anxiety (Read codes) diagnostic Read
E202000 Phobia unspecified res173: Anxiety (Read codes) diagnostic Read
E202100 Agoraphobia with panic attacks res173: Anxiety (Read codes) diagnostic Read
E202199 Agoraphobia res173: Anxiety (Read codes) diagnostic Read
E202200 Agoraphobia without mention of panic attacks res173: Anxiety (Read codes) diagnostic Read
E202299 Agoraphobia res173: Anxiety (Read codes) diagnostic Read
E202300 Social phobia, fear of eating in public res173: Anxiety (Read codes) diagnostic Read
E202400 Social phobia, fear of public speaking res173: Anxiety (Read codes) diagnostic Read
E202500 Social phobia, fear of public washing res173: Anxiety (Read codes) diagnostic Read
E202600 Acrophobia res173: Anxiety (Read codes) diagnostic Read
E202800 Claustrophobia res173: Anxiety (Read codes) diagnostic Read
E202z00 Phobic disorder NOS res173: Anxiety (Read codes) diagnostic Read
E202z98 Needle phobia res173: Anxiety (Read codes) diagnostic Read
E202z99 Other phobias res173: Anxiety (Read codes) diagnostic Read
E203.00 Obsessive-compulsive disorders res173: Anxiety (Read codes) diagnostic Read
E203.11 Anancastic neurosis res173: Anxiety (Read codes) diagnostic Read
E203000 Compulsive neurosis res173: Anxiety (Read codes) diagnostic Read
E203100 Obsessional neurosis res173: Anxiety (Read codes) diagnostic Read
E203z00 Obsessive-compulsive disorder NOS res173: Anxiety (Read codes) diagnostic Read
E20z.00 Neurotic disorder NOS res173: Anxiety (Read codes) diagnostic Read
E28z.12 Flying phobia res173: Anxiety (Read codes) diagnostic Read
E29y199 Chron post-traum stress dis res173: Anxiety (Read codes) diagnostic Read
Eu05400 [X]Organic anxiety disorder res173: Anxiety (Read codes) diagnostic Read
Eu34114 [X]Persistant anxiety depression res173: Anxiety (Read codes) diagnostic Read
Eu40.00 [X]Phobic anxiety disorders res173: Anxiety (Read codes) diagnostic Read
Eu40000 [X]Agoraphobia res173: Anxiety (Read codes) diagnostic Read
Eu40011 [X]Agoraphobia without history of panic disorder res173: Anxiety (Read codes) diagnostic Read
Eu40012 [X]Panic disorder with agoraphobia res173: Anxiety (Read codes) diagnostic Read
Eu40100 [X]Social phobias res173: Anxiety (Read codes) diagnostic Read
Eu40111 [X]Anthropophobia res173: Anxiety (Read codes) diagnostic Read
Eu40112 [X]Social neurosis res173: Anxiety (Read codes) diagnostic Read
Eu40200 [X]Specific (isolated) phobias res173: Anxiety (Read codes) diagnostic Read
Eu40211 [X]Acrophobia res173: Anxiety (Read codes) diagnostic Read
Eu40212 [X]Animal phobias res173: Anxiety (Read codes) diagnostic Read
Eu40213 [X]Claustrophobia res173: Anxiety (Read codes) diagnostic Read
Eu40214 [X]Simple phobia res173: Anxiety (Read codes) diagnostic Read
Eu40299 Needle phobia res173: Anxiety (Read codes) diagnostic Read
Eu40300 [X]Needle phobia res173: Anxiety (Read codes) diagnostic Read
Eu40y00 [X]Other phobic anxiety disorders res173: Anxiety (Read codes) diagnostic Read
Eu40z00 [X]Phobic anxiety disorder, unspecified res173: Anxiety (Read codes) diagnostic Read
Eu40z11 [X]Phobia NOS res173: Anxiety (Read codes) diagnostic Read
Eu40z12 [X]Phobic state NOS res173: Anxiety (Read codes) diagnostic Read
Eu41.00 [X]Other anxiety disorders res173: Anxiety (Read codes) diagnostic Read
Eu41000 [X]Panic disorder [episodic paroxysmal anxiety] res173: Anxiety (Read codes) diagnostic Read
Eu41011 [X]Panic attack res173: Anxiety (Read codes) diagnostic Read
Eu41012 [X]Panic state res173: Anxiety (Read codes) diagnostic Read
Eu41100 [X]Generalized anxiety disorder res173: Anxiety (Read codes) diagnostic Read
Eu41111 [X]Anxiety neurosis res173: Anxiety (Read codes) diagnostic Read
Eu41200 [X]Mixed anxiety and depressive disorder res173: Anxiety (Read codes) diagnostic Read
Eu41211 [X]Mild anxiety depression res173: Anxiety (Read codes) diagnostic Read
Eu41300 [X]Other mixed anxiety disorders res173: Anxiety (Read codes) diagnostic Read
Eu41y00 [X]Other specified anxiety disorders res173: Anxiety (Read codes) diagnostic Read
Eu41y11 [X]Anxiety hysteria res173: Anxiety (Read codes) diagnostic Read
Eu41z00 [X]Anxiety disorder, unspecified res173: Anxiety (Read codes) diagnostic Read
Eu42.00 [X]Obsessive - compulsive disorder res173: Anxiety (Read codes) diagnostic Read
Eu42.12 [X]Obsessive-compulsive neurosis res173: Anxiety (Read codes) diagnostic Read
Eu42000 [X]Predominantly obsessional thoughts or ruminations res173: Anxiety (Read codes) diagnostic Read
Eu42200 [X]Mixed obsessional thoughts and acts res173: Anxiety (Read codes) diagnostic Read
Eu42y00 [X]Other obsessive-compulsive disorders res173: Anxiety (Read codes) diagnostic Read
Eu42z00 [X]Obsessive-compulsive disorder, unspecified res173: Anxiety (Read codes) diagnostic Read
Eu43013 [X]Combat fatigue res173: Anxiety (Read codes) diagnostic Read
Eu43100 [X]Post - traumatic stress disorder res173: Anxiety (Read codes) diagnostic Read
Eu43300 [X]Acute post-traumatic stress disorder follow military comb res173: Anxiety (Read codes) diagnostic Read
Eu43400 [X]Chron post-traumatic stress disorder follow military comb res173: Anxiety (Read codes) diagnostic Read
Eu43500 [X]Delayed post-traumat stress disorder follow military comb res173: Anxiety (Read codes) diagnostic Read
Eu93000 [X]Separation anxiety disorder of childhood res173: Anxiety (Read codes) diagnostic Read
Eu93100 [X]Phobic anxiety disorder of childhood res173: Anxiety (Read codes) diagnostic Read
Eu93200 [X]Social anxiety disorder of childhood res173: Anxiety (Read codes) diagnostic Read
Eu93y12 [X]Childhood overanxious disorder res173: Anxiety (Read codes) diagnostic Read
Z481.00 Phobia counselling res173: Anxiety (Read codes) diagnostic Read
Z4L1.00 Anxiety counselling res173: Anxiety (Read codes) diagnostic Read
Z522600 Flooding - obsessional compulsive disorder res173: Anxiety (Read codes) diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH829/version/1737/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH829/version/1737/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('PH829', '1737', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH829/version/1737/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH829/version/1737/export/codes/?format=json
CSV site_root/phenotypes/PH829/version/1737/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('PH829', '1737', api_client=client)

Version History

Version
ID
Name Owner Publish date
1737 Anxiety ieuan.scanlon 2022-04-04 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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