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

  1. Overview

    Phenotype Type
    Disease or syndrome
    Sex
    Both
    Valid Event Date Range
    01/01/2010 - 30/06/2020
    Coding System
    Read codes v2
    Data Sources
    CPRD GOLD
    CPRD Aurum
    Collections
    ClinicalCodes RepositoryPhenotype Library
    Tags
    No data
    Ontology
    No data

  2. 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.

  3. Implementation

    Implementation

    No data

  4. Clinical Code List

  5. Publication

    Related 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.

    Citation Example

    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 - Self Harm. Phenotype Library [Online]. 04 April 2022. Available from: http://phenotypes.healthdatagateway.org/phenotypes/PH838/version/1755/detail/. [Accessed 25 April 2025]

  6. API

    To Export Phenotype Details:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH838/version/1755/detail/?format=json
    R Package

    # Download here

    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

    # Download here

    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:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH838/version/1755/export/codes/?format=json
    R Package

    # Download here

    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

    # Download here

    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
    )

  7. Version History

    Version IDNameOwnerPublish date
    Self Harm ieuan.scanlon2022-04-04 07:06