Self Harm
Matthew J Carr, Sarah Steeg, Roger T Webb, Nav Kapur, Carolyn A Chew-Graham, Kathryn M Abel, Holly Hope, Matthias Pierce, Darren M. Ashcroft
PH838 / 1755 Clinical-Coded Phenotype
Overview
Phenotype TypeDisease or syndromeSexBothValid Event Date Range01/01/2010 - 30/06/2020Coding SystemRead codes v2Data SourcesCollectionsClinicalCodes RepositoryPhenotype LibraryTagsNo dataDefinition
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.
Implementation
No dataImplementation
Clinical Code List
PUBLISHED - 720 Codes
Publication
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 PrePrint not peer reviewed, 2020.
No dataCitation Requirements
API
To Export Phenotype Details:
Format API JSON site_root/api/v1/phenotypes/PH838/version/1755/detail/?format=json R Package library(ConceptLibraryClient)
# Connect to API
client = ConceptLibraryClient::Connection$new(public=TRUE)
# Get details of phenotype
phenotype_details = client$phenotypes$get_detail(
'PH838',
version_id=1755
)Py Package from pyconceptlibraryclient import Client
# Connect to API
client = Client(public=True)
# Get codelist of phenotype
phenotype_codelist = client.phenotypes.get_detail(
'PH838',
version_id=1755
)To Export Phenotype Code List:
Format API JSON site_root/api/v1/phenotypes/PH838/version/1755/export/codes/?format=json CSV site_root/phenotypes/PH838/version/1755/export/codes/ R Package library(ConceptLibraryClient)
# Connect to API
client = ConceptLibraryClient::Connection$new(public=TRUE)
# Get codelist of phenotype
phenotype_codelist = client$phenotypes$get_codelist(
'PH838',
version_id=1755
)Py Package from pyconceptlibraryclient import Client
# Connect to API
client = Client(public=True)
# Get codelist of phenotype
phenotype_codelist = client.phenotypes.get_codelist(
'PH838',
version_id=1755
)Version History