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Schizophrenia

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH892
Version ID
1863
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2018-10-15
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

Self-harm is a major risk factor for suicide, with older adults (older than 65 years) having reportedly greater suicidal intent than any other age group. With the aging population rising and paucity of research focus in this age group, the extent of the problem of self-harm needs to be established. In a primary care cohort of older adults we aimed to investigate the incidence of self-harm, subsequent clinical management, prevalence of mental and physical diagnoses, and unnatural-cause mortality risk, including suicide.

Methods:

The UK Clinical Practice Research Datalink contains anonymised patient records from general practice that routinely capture clinical information pertaining to both primary and secondary care services. We identified 4124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001–14. We calculated standardised incidence and in 2854 adults with at least 12 months follow-up examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm. We estimated prevalence of mental and physical illness diagnoses before and after self-harm and, using Cox regression in a matched cohort, we examined cause-specific mortality risks.

Findings:

Overall incidence of self-harm in older adults aged 65 years and older was 4·1 per 10 000 person-years with stable gender-specific rates observed over the 13-year period. After self-harm, 335 (11·7%) of 2854 adults were referred to mental health services, 1692 (59·3%) were prescribed an antidepressant, and 336 (11·8%) were prescribed a tricyclic antidepressant (TCA). Having a diagnosed previous mental illness was twice as prevalent in the self-harm cohort as in the comparison cohort (prevalence ratio 2·10 [95% CI 2·03–2·17]) and with a previous physical health condition prevalence was 20% higher in the self-harm cohort compared to the comparison cohort (1·20 [1·17–1·23]). Adults from the self-harm cohort (n=2454) died from unnatural causes an estimated 20 times more frequently than the comparison cohort (n=48 921) during the first year. A markedly elevated risk of suicide (hazard ratio 145·4 [95% CI 53·9–392·3]) was observed in the self-harm cohort.

Interpretation:

Within primary care, we have identified a group of older adults at high risk from unnatural death, particularly within the first year of self-harm. We have highlighted a high frequency of prescription of TCAs, known to be potentially fatally toxic in overdose. We emphasise the need for early intervention, careful alternative prescribing, and increased support when older adults consult after an episode of self-harm and with other health conditions.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft, Self-harm in a primary care cohort of older people incidence, clinical management, and risk of suicide and other causes of death. Psychiatry, 5, 2018.

Clinical Code List

Rows: 181
Code Description Entity type Coding System (ICD-10 Read) Category
1BH..00 delusions res69: schizophrenia Read diagnostic
1BH..11 delusion res69: schizophrenia Read diagnostic
1BH0.00 delusion of persecution res69: schizophrenia Read diagnostic
1BH1.00 grandiose delusions res69: schizophrenia Read diagnostic
225E.00 o/e - paranoid delusions res69: schizophrenia Read diagnostic
225F.00 o/e - delusion of persecution res69: schizophrenia Read diagnostic
285..11 psychotic condition, insight present res69: schizophrenia Read diagnostic
E1...00 Non-organic psychoses res69: schizophrenia Read diagnostic
E10..00 Schizophrenic disorders res69: schizophrenia Read diagnostic
E100.00 Simple schizophrenia res69: schizophrenia Read diagnostic
E100.11 Schizophrenia simplex res69: schizophrenia Read diagnostic
E100000 Unspecified schizophrenia res69: schizophrenia Read diagnostic
E100100 Subchronic schizophrenia res69: schizophrenia Read diagnostic
E100200 Chronic schizophrenic res69: schizophrenia Read diagnostic
E100300 Acute exacerbation of subchronic schizophrenia res69: schizophrenia Read diagnostic
E100400 Acute exacerbation of chronic schizophrenia res69: schizophrenia Read diagnostic
E100500 Schizophrenia in remission res69: schizophrenia Read diagnostic
E100z00 Simple schizophrenia NOS res69: schizophrenia Read diagnostic
E101.00 Hebephrenic schizophrenia res69: schizophrenia Read diagnostic
E101000 Unspecified hebephrenic schizophrenia res69: schizophrenia Read diagnostic
E101400 Acute exacerbation of chronic hebephrenic schizophrenia res69: schizophrenia Read diagnostic
E101500 Hebephrenic schizophrenia in remission res69: schizophrenia Read diagnostic
E101z00 Hebephrenic schizophrenia NOS res69: schizophrenia Read diagnostic
E102.00 catatonic schizophrenia res69: schizophrenia Read diagnostic
E102000 unspecified catatonic schizophrenia res69: schizophrenia Read diagnostic
E102100 subchronic catatonic schizophrenia res69: schizophrenia Read diagnostic
E102400 acute exacerbation of chronic catatonic schizophrenia res69: schizophrenia Read diagnostic
E102500 Catatonic schizophrenia in remission res69: schizophrenia Read diagnostic
E102z00 catatonic schizophrenia nos res69: schizophrenia Read diagnostic
E103.00 paranoid schizophrenia res69: schizophrenia Read diagnostic
E103000 unspecified paranoid schizophrenia res69: schizophrenia Read diagnostic
E103100 subchronic paranoid schizophrenia res69: schizophrenia Read diagnostic
E103200 Chronic paranoid schizophrenia res69: schizophrenia Read diagnostic
E103300 Acute exacerbation of subchronic paranoid schizophrenia res69: schizophrenia Read diagnostic
E103400 Acute exacerbation of chronic paranoid schizophrenia res69: schizophrenia Read diagnostic
E103500 Paranoid schizophrenia in remission res69: schizophrenia Read diagnostic
E103z00 Paranoid schizophrenia NOS res69: schizophrenia Read diagnostic
E104.00 Acute schizophrenic episode res69: schizophrenia Read diagnostic
E105.00 Latent schizophrenia res69: schizophrenia Read diagnostic
E105000 Unspecified latent schizophrenia res69: schizophrenia Read diagnostic
E105200 Chronic latent schizophrenia res69: schizophrenia Read diagnostic
E105500 Latent schizophrenia in remission res69: schizophrenia Read diagnostic
E105z00 Latent schizophrenia NOS res69: schizophrenia Read diagnostic
E106.00 Residual schizophrenia res69: schizophrenia Read diagnostic
E107.00 Schizo-affective schizophrenia res69: schizophrenia Read diagnostic
E107.11 cyclic schizophrenia res69: schizophrenia Read diagnostic
E107000 Unspecified schizo-affective schizophrenia res69: schizophrenia Read diagnostic
E107100 Subchronic schizo-affective schizophrenia res69: schizophrenia Read diagnostic
E107200 Chronic schizo-affective schizophrenia res69: schizophrenia Read diagnostic
E107300 Acute exacerbation subchronic schizo-affective schizophrenia res69: schizophrenia Read diagnostic
E107400 Acute exacerbation of chronic schizo-affective schizophrenia res69: schizophrenia Read diagnostic
E107500 Schizo-affective schizophrenia in remission res69: schizophrenia Read diagnostic
E107z00 Schizo-affective schizophrenia NOS res69: schizophrenia Read diagnostic
E10y.00 Other schizophrenia res69: schizophrenia Read diagnostic
E10y.11 cenesthopathic schizophrenia res69: schizophrenia Read diagnostic
E10y000 atypical schizophrenia res69: schizophrenia Read diagnostic
E10y100 coenesthopathic schizophrenia res69: schizophrenia Read diagnostic
E10yz00 other schizophrenia nos res69: schizophrenia Read diagnostic
E10z.00 schizophrenia nos res69: schizophrenia Read diagnostic
E11z.00 Other and unspecified affective psychoses res69: schizophrenia Read diagnostic
E11z000 Unspecified affective psychoses NOS res69: schizophrenia Read diagnostic
E11zz00 Other affective psychosis NOS res69: schizophrenia Read diagnostic
E121.00 chronic paranoid psychosis res69: schizophrenia Read diagnostic
E122.00 paraphrenia res69: schizophrenia Read diagnostic
E123.00 shared paranoid disorder res69: schizophrenia Read diagnostic
E12y000 paranoia querulans res69: schizophrenia Read diagnostic
E12z.00 paranoid psychosis nos res69: schizophrenia Read diagnostic
E13..00 Other nonorganic psychoses res69: schizophrenia Read diagnostic
E13..11 reactive psychoses res69: schizophrenia Read diagnostic
E130.00 reactive depressive psychosis res69: schizophrenia Read diagnostic
E130.11 psychotic reactive depression res69: schizophrenia Read diagnostic
E133.00 acute paranoid reaction res69: schizophrenia Read diagnostic
E134.00 psychogenic paranoid psychosis res69: schizophrenia Read diagnostic
E13z.00 Nonorganic psychosis NOS res69: schizophrenia Read diagnostic
E13z.11 Psychotic episode NOS res69: schizophrenia Read diagnostic
E14..00 Psychoses with origin in childhood res69: schizophrenia Read diagnostic
E141.00 Disintegrative psychosis res69: schizophrenia Read diagnostic
E141100 Residual disintegrative psychoses res69: schizophrenia Read diagnostic
E14y.00 Other childhood psychoses res69: schizophrenia Read diagnostic
E14yz00 Other childhood psychoses NOS res69: schizophrenia Read diagnostic
E14z.00 Child psychosis NOS res69: schizophrenia Read diagnostic
E14z.11 Childhood schizophrenia NOS res69: schizophrenia Read diagnostic
E1y..00 Other specified non-organic psychoses res69: schizophrenia Read diagnostic
E1z..00 Non-organic psychosis NOS res69: schizophrenia Read diagnostic
Eu02z12 [X] Presenile psychosis NOS res69: schizophrenia Read diagnostic
Eu0z.12 [X]Symptomatic psychosis NOS res69: schizophrenia Read diagnostic
Eu2..00 [X]Schizophrenia, schizotypal and delusional disorders res69: schizophrenia Read diagnostic
Eu20.00 [X]Schizophrenia res69: schizophrenia Read diagnostic
Eu20000 [X]Paranoid schizophrenia res69: schizophrenia Read diagnostic
Eu20011 [X]Paraphrenic schizophrenia res69: schizophrenia Read diagnostic
Eu20100 [X]Hebephrenic schizophrenia res69: schizophrenia Read diagnostic
Eu20111 [X]Disorganised schizophrenia res69: schizophrenia Read diagnostic
Eu20200 [X]Catatonic schizophrenia res69: schizophrenia Read diagnostic
Eu20211 [X]Catatonic stupor res69: schizophrenia Read diagnostic
Eu20212 [X]Schizophrenic catalepsy res69: schizophrenia Read diagnostic
Eu20213 [X]Schizophrenic catatonia res69: schizophrenia Read diagnostic
Eu20214 [X]Schizophrenic flexibilatis cerea res69: schizophrenia Read diagnostic
Eu20300 [X]Undifferentiated schizophrenia res69: schizophrenia Read diagnostic
Eu20311 [X]Atypical schizophrenia res69: schizophrenia Read diagnostic
Eu20500 [X]Residual schizophrenia res69: schizophrenia Read diagnostic
Eu20511 [X]Chronic undifferentiated schizophrenia res69: schizophrenia Read diagnostic
Eu20600 [X]Simple schizophrenia res69: schizophrenia Read diagnostic
Eu20y00 [X]Other schizophrenia res69: schizophrenia Read diagnostic
Eu20y12 [X]Schizophreniform disord NOS res69: schizophrenia Read diagnostic
Eu20y13 [X]Schizophrenifrm psychos NOS res69: schizophrenia Read diagnostic
Eu20z00 [X]Schizophrenia, unspecified res69: schizophrenia Read diagnostic
Eu21.11 [X]Latent schizophrenic reaction res69: schizophrenia Read diagnostic
Eu21.13 [X]Latent schizophrenia res69: schizophrenia Read diagnostic
Eu21.14 [X]Prepsychotic schizophrenia res69: schizophrenia Read diagnostic
Eu21.15 [X]Prodromal schizophrenia res69: schizophrenia Read diagnostic
Eu21.16 [X]Pseudoneurotic schizophrenia res69: schizophrenia Read diagnostic
Eu21.17 [X]Pseudopsychopathic schizophrenia res69: schizophrenia Read diagnostic
Eu22.00 [X]Persistent delusional disorders res69: schizophrenia Read diagnostic
Eu22000 [X]Delusional disorder res69: schizophrenia Read diagnostic
Eu22011 [X]Paranoid psychosis res69: schizophrenia Read diagnostic
Eu22012 [X]Paranoid state res69: schizophrenia Read diagnostic
Eu22013 [X]Paraphrenia - late res69: schizophrenia Read diagnostic
Eu22014 [X]Sensitiver Beziehungswahn res69: schizophrenia Read diagnostic
Eu22015 [X]Paranoia res69: schizophrenia Read diagnostic
Eu22100 [X]Delusional misidentification syndrome res69: schizophrenia Read diagnostic
Eu22111 [X]Capgras syndrome res69: schizophrenia Read diagnostic
Eu22y00 [X]Other persistent delusional disorders res69: schizophrenia Read diagnostic
Eu22y11 [X]Delusional dysmorphophobia res69: schizophrenia Read diagnostic
Eu22y12 [X]Involutional paranoid state res69: schizophrenia Read diagnostic
Eu22z00 [X]Persistent delusional disorder, unspecified res69: schizophrenia Read diagnostic
Eu23.00 [X]Acute and transient psychotic disorders res69: schizophrenia Read diagnostic
Eu23000 [X]Acute polymorphic psychot disord without symp of schizoph res69: schizophrenia Read diagnostic
Eu23012 [X]Cycloid psychosis res69: schizophrenia Read diagnostic
Eu23100 [X]Acute polymorphic psychot disord with symp of schizophren res69: schizophrenia Read diagnostic
Eu23112 [X]Cycloid psychosis with symptoms of schizophrenia res69: schizophrenia Read diagnostic
Eu23200 [X]Acute schizophrenia-like psychotic disorder res69: schizophrenia Read diagnostic
Eu23211 [X]Brief schizophreniform disorder res69: schizophrenia Read diagnostic
Eu23212 [X]Brief schizophrenifrm psych res69: schizophrenia Read diagnostic
Eu23214 [X]Schizophrenic reaction res69: schizophrenia Read diagnostic
Eu23300 [X]Other acute predominantly delusional psychotic disorders res69: schizophrenia Read diagnostic
Eu23312 [X]Psychogenic paranoid psychosis res69: schizophrenia Read diagnostic
Eu23y00 [X]Other acute and transient psychotic disorders res69: schizophrenia Read diagnostic
Eu23z00 [X]Acute and transient psychotic disorder, unspecified res69: schizophrenia Read diagnostic
Eu24.00 [x]induced delusional disorder res69: schizophrenia Read diagnostic
Eu24.12 [x]induced paranoid disorder res69: schizophrenia Read diagnostic
Eu24.13 [x]induced psychotic disorder res69: schizophrenia Read diagnostic
Eu25.00 [X]Schizoaffective disorders res69: schizophrenia Read diagnostic
Eu25000 [x]schizoaffective disorder, manic type res69: schizophrenia Read diagnostic
Eu25011 [x]schizoaffective psychosis, manic type res69: schizophrenia Read diagnostic
Eu25012 [x]schizophreniform psychosis, manic type res69: schizophrenia Read diagnostic
Eu25100 [X]Schizoaffective disorder, depressive type res69: schizophrenia Read diagnostic
Eu25111 [X]Schizoaffective psychosis, depressive type res69: schizophrenia Read diagnostic
Eu25112 [x]schizophreniform psychosis, depressive type res69: schizophrenia Read diagnostic
Eu25200 [X]Schizoaffective disorder, mixed type res69: schizophrenia Read diagnostic
Eu25211 [x]cyclic schizophrenia res69: schizophrenia Read diagnostic
Eu25212 [X]Mixed schizophrenic and affective psychosis res69: schizophrenia Read diagnostic
Eu25y00 [X]Other schizoaffective disorders res69: schizophrenia Read diagnostic
Eu25z00 [X]Schizoaffective disorder, unspecified res69: schizophrenia Read diagnostic
Eu25z11 [X]Schizoaffective psychosis NOS res69: schizophrenia Read diagnostic
Eu2y.00 [X]Other nonorganic psychotic disorders res69: schizophrenia Read diagnostic
Eu2y.11 [x]chronic hallucinatory psychosis res69: schizophrenia Read diagnostic
Eu2z.00 [X]Unspecified nonorganic psychosis res69: schizophrenia Read diagnostic
Eu2z.11 [x]psychosis nos res69: schizophrenia Read diagnostic
Eu32300 [x]severe depressive episode with psychotic symptoms res69: schizophrenia Read diagnostic
Eu32311 [x]single episode of major depression and psychotic symptoms res69: schizophrenia Read diagnostic
Eu32312 [x]single episode of psychogenic depressive psychosis res69: schizophrenia Read diagnostic
Eu32313 [x]single episode of psychotic depression res69: schizophrenia Read diagnostic
Eu32314 [x]single episode of reactive depressive psychosis res69: schizophrenia Read diagnostic
Eu32900 [X]Single major depr ep, severe with psych, psych in remiss res69: schizophrenia Read diagnostic
Eu32A00 [X]Recurr major depr ep, severe with psych, psych in remiss res69: schizophrenia Read diagnostic
Eu33300 [X]Recurrent depress disorder cur epi severe with psyc symp res69: schizophrenia Read diagnostic
Eu33311 [x]endogenous depression with psychotic symptoms res69: schizophrenia Read diagnostic
Eu33313 [x]recurr severe episodes/major depression+psychotic symptom res69: schizophrenia Read diagnostic
Eu33314 [x]recurr severe episodes/psychogenic depressive psychosis res69: schizophrenia Read diagnostic
Eu33315 [x]recurrent severe episodes of psychotic depression res69: schizophrenia Read diagnostic
Eu33316 [x]recurrent severe episodes/reactive depressive psychosis res69: schizophrenia Read diagnostic
Eu44.14 [x]hysterical psychosis res69: schizophrenia Read diagnostic
Eu84314 [x]symbiotic psychosis res69: schizophrenia Read diagnostic
Eu84512 [X]Schizoid disorder of childhood res69: schizophrenia Read diagnostic
R001000 [d]hallucinations, auditory res69: schizophrenia Read diagnostic
R001100 [d]hallucinations, gustatory res69: schizophrenia Read diagnostic
R001200 [d]hallucinations, olfactory res69: schizophrenia Read diagnostic
R001300 [d]hallucinations, tactile res69: schizophrenia Read diagnostic
R001z00 [d]hallucinations nos res69: schizophrenia Read diagnostic
Ryu5300 [x]other hallucinations res69: schizophrenia Read diagnostic
ZS7C611 schizophrenic language res69: schizophrenia Read diagnostic
Rows: 1
Code Description Entity type Coding System (ICD-10 Read) Category
F20-F29 Schizophrenia, schizotypal and delusional disorders res69: schizophrenia ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH892/version/1863/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH892/version/1863/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('PH892', '1863', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH892/version/1863/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH892/version/1863/export/codes/?format=json
CSV site_root/phenotypes/PH892/version/1863/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('PH892', '1863', api_client=client)

Version History

Version
ID
Name Owner Publish date
1863 Schizophrenia ieuan.scanlon 2022-04-04 currently shown

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