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Article ; Online: Recognizing the complexities of co-prescriptions and life-style factors in opioid agonist treatment: A response from Eleni Domzaridou, Matthew J. Carr, Tim Millar, Roger T. Webb and Darren M. Ashcroft.

Domzaridou, Eleni / Carr, Matthew J / Millar, Tim / Webb, Roger T / Ashcroft, Darren M

2024 Volume 119, Issue 5, Page(s) 967–968

MeSH term(s)	Humans ; Analgesics, Opioid/therapeutic use ; Prescriptions ; Drug Overdose/drug therapy ; Benzodiazepines ; Retrospective Studies
Chemical Substances	Analgesics, Opioid ; Benzodiazepines (12794-10-4)
Language	English
Publishing date	2024-02-05
Publishing country	England
Document type	Letter
ZDB-ID	1141051-6
ISSN	1360-0443 ; 0965-2140
ISSN (online)	1360-0443
ISSN	0965-2140
DOI	10.1111/add.16447
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Article ; Online: Risk factors for deaths of despair in England: An ecological study of local authority mortality data.

Camacho, Christine / Webb, Roger T / Bower, Peter / Munford, Luke

Social science & medicine (1982)

2024 Volume 342, Page(s) 116560

Abstract: Deaths of Despair (DoD) are socially patterned fatalities encompassing those attributable to drug and alcohol misuse and suicide. DoD occur much more frequently in socially deprived communities. This ecological study aimed to yield new knowledge on the ... ...

Abstract	Deaths of Despair (DoD) are socially patterned fatalities encompassing those attributable to drug and alcohol misuse and suicide. DoD occur much more frequently in socially deprived communities. This ecological study aimed to yield new knowledge on the spatial distribution of DoD, and socioeconomic factors that predict DoD risk in England. Via ICD-10 coding, deaths nationally during 2019-2021 were classified to non-overlapping categories of drug-related death, alcohol-specific death, and suicide. The proportion of DoD from each of these causes was calculated and age standardised DoD rates were generated for local authorities. A multivariable regression model for DoD risk was developed using 25 socioeconomic indicators. In 2019-2021, an estimated 46,200 people lost their lives due to DoD. Rates were higher in the North and in coastal areas (p < 0.001), ranging regionally from 25.1/100,000 (SD 6.3) in London to 54.7/100,000 (SD 9.5) in the North East. Alcohol-specific deaths were the largest contributor of DoD, accounting for 44.1% (95%CI 43.5-44.8%) of all such deaths. Living in the North, unemployment, White British ethnicity, living alone, economic inactivity, employment in elementary occupations, and living in urban areas were significantly associated with elevated DoD risk. DoD in England are spatially patterned, with northern regions experiencing a much higher burden of mortality from these avoidable causes. This study provides novel insights into the area-level factors associated with DoD in England. Potential ecological error is a key limitation.
MeSH term(s)	Humans ; Health Status Disparities ; England/epidemiology ; Socioeconomic Factors ; Risk Factors ; Employment ; Ethanol ; Mortality
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2024-01-05
Publishing country	England
Document type	Journal Article
ZDB-ID	4766-1
ISSN	1873-5347 ; 0037-7856 ; 0277-9536
ISSN (online)	1873-5347
ISSN	0037-7856 ; 0277-9536
DOI	10.1016/j.socscimed.2024.116560
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Article ; Online: COVID-19, young people, and suicidal behaviour.

Steeg, Sarah / Webb, Roger T / Wilkinson, Jack / Kapur, Nav

The lancet. Psychiatry

2023 Volume 10, Issue 7, Page(s) 483–484

MeSH term(s)	Humans ; Adolescent ; Suicidal Ideation ; COVID-19 ; Suicide ; Suicide, Attempted
Language	English
Publishing date	2023-06-20
Publishing country	England
Document type	Letter ; Comment
ISSN	2215-0374
ISSN (online)	2215-0374
DOI	10.1016/S2215-0366(23)00140-2
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Article ; Online: The enduring effect of early life adversities on health trajectories.

Webb, Roger T / John, Ann / Mytton, Julie

The Lancet. Public health

2021 Volume 6, Issue 11, Page(s) e785–e786

Language	English
Publishing date	2021-09-30
Publishing country	England
Document type	Journal Article ; Comment
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(21)00187-0
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Article ; Online: A Systematic Review of Interpersonal Violence Perpetration and Victimization Risk Examined Within Single Study Cohorts, Including in Relation to Mental Illness.

Marr, Carey / Webb, Roger T / Yee, Natalia / Dean, Kimberlie

Trauma, violence & abuse

2023 Volume 25, Issue 1, Page(s) 130–149

Abstract: Rates of both violent victimization and violence perpetration are known to be elevated among individuals with mental illness compared with those in the general population, though the relative risk of each outcome is less well established. In this ... ...

Abstract	Rates of both violent victimization and violence perpetration are known to be elevated among individuals with mental illness compared with those in the general population, though the relative risk of each outcome is less well established. In this systematic review, PubMed, Embase, Web of Science, PsycINFO, and Criminal Justice Abstracts were searched for articles published any time before October 2021 that reported the prevalence or incidence of both violent victimization and perpetration. We performed two searches to identify studies using samples or cohorts of (1) persons with mental illnesses and (2) persons in the general population. A total of 25 studies (9 examining persons with mental illnesses, 13 examining persons in the general population, and 3 examining both sample/cohort types) were identified and data was extracted to describe the type and size of cohort or sample, definitions and terminology (i.e., mental illness, violence victimization, violence perpetration), data source(s), observation period, prevalence/incidence of victimization, and prevalence/incidence of perpetration. The Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data was used to conduct a quality assessment of all included studies. Due to marked study heterogeneity, results were presented using a narrative synthesis approach. Across studies, findings were mixed, and the methodological approaches varied greatly. Broadly, the review provides evidence for (1) higher rates of victimization than perpetration for both individuals with mental illness and those in the general population and (2) higher rates of both victimization and perpetration for those with mental illness compared to those in the general population.
MeSH term(s)	Humans ; Crime Victims ; Mental Disorders/epidemiology ; Violence
Language	English
Publishing date	2023-02-03
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2070884-1
ISSN	1552-8324 ; 1524-8380
ISSN (online)	1552-8324
ISSN	1524-8380
DOI	10.1177/15248380221145732
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Article ; Online: Deaths of despair in England: an observational study of local authority mortality data.

Camacho, Christine / Webb, Roger T / Bower, Peter / Munford, Luke

Lancet (London, England)

2023 Volume 402 Suppl 1, Page(s) S31

Abstract: Background: Deaths of Despair (DoD) are socially patterned causes of death encompassing drug and alcohol misuse and suicide. DoDs are strongly associated with socioeconomic disadvantage. England has high levels of inequalities, so we hypothesised the ... ...

Abstract	Background: Deaths of Despair (DoD) are socially patterned causes of death encompassing drug and alcohol misuse and suicide. DoDs are strongly associated with socioeconomic disadvantage. England has high levels of inequalities, so we hypothesised the existence of marked geographical variations in DoD. We aimed to yield new knowledge on the spatial distribution of DoD, and area-level socioeconomic factors that predict DoD risk in England. Methods: This observational study was conducted using ICD-10 coded deaths for 307 local authorities in England during 2019-21. Deaths were grouped to non-overlapping categories of drug-related death, alcohol-specific death, and suicide. The mean contributions of each of these causes to the total number of DoD in England were calculated with Poisson exact confidence intervals. Standardised mortality ratios (SMRs) for DoD were generated for each local authority population. A multivariable regression model for DoD risk was developed using 25 socioeconomic variables. Findings: An estimated 46 200 people lost their lives due to DoD between Jan 1, 2019, and Dec 31, 2021. Regional SMRs ranged from 57·4 (SD 16·1) in London to 144·1 (SD 26·8) in the northeast of England (p<0·0001). Alcohol-specific deaths were the largest contributor of DoD, accounting for 44·1% of DoD (95% CI 43·5-44·8), followed by drug-related death (28·1%, 27·7-28·6) and suicide (27·7%, 27·2-28·2). Living in the North, living alone, White British ethnicity, lower inward migration, economic inactivity, income deprivation in older people, employment in elementary occupations, unemployment, and education deprivation in adults were significantly associated with higher DoD rates in England. Interpretation: DoD in England are spatially patterned, with northern regions experiencing a considerably higher burden of mortality from these avoidable causes. A key limitation is ecological bias. This study provides novel insights into area-level risk factors for DoD in England. Funding: National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester (ARC-GM).
MeSH term(s)	Adult ; Humans ; Aged ; England/epidemiology ; Suicide ; Socioeconomic Factors ; Risk Factors ; London
Language	English
Publishing date	2023-11-23
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(23)02124-4
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Article: Editorial: Mortality Risk and Related Adverse Outcomes Following Discharge From Inpatient Psychiatric Care.

Nordentoft, Merete / Caine, Eric D / Webb, Roger T

Frontiers in psychiatry

2021 Volume 12, Page(s) 763342

Language	English
Publishing date	2021-09-27
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2021.763342
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Article ; Online: Strong evidence indicating the effectiveness of opioid agonist treatment.

Millar, Tim / Webb, Roger T

The Lancet. Public health

2019 Volume 4, Issue 7, Page(s) e314–e315

MeSH term(s)	Analgesics, Opioid ; Criminal Law ; Humans ; Retrospective Studies
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2019-06-12
Publishing country	England
Document type	Journal Article ; Comment
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(19)30100-8
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Article ; Online: Identifying prior signals of bipolar disorder using primary care electronic health records: a nested case-control study.

Morgan, Catharine / Ashcroft, Darren M / Chew-Graham, Carolyn A / Sperrin, Matthew / Webb, Roger T / Francis, Anya / Scott, Jan / Yung, Alison R

The British journal of general practice : the journal of the Royal College of General Practitioners

2024

Abstract: Background: Bipolar disorders are serious mental illnesses, yet evidence suggests that the diagnosis and treatment of bipolar disorder can be delayed by around 6 years.: Aim: To identify signals of undiagnosed bipolar disorder using routinely ... ...

Abstract	Background: Bipolar disorders are serious mental illnesses, yet evidence suggests that the diagnosis and treatment of bipolar disorder can be delayed by around 6 years. Aim: To identify signals of undiagnosed bipolar disorder using routinely collected electronic health records. Design and setting: A nested case-control study conducted using the UK Clinical Practice Research Datalink (CPRD) GOLD dataset, an anonymised electronic primary care patient database linked with hospital records. 'Cases' were adult patients with incident bipolar disorder diagnoses between 1 January 2010 and 31 July 2017. Method: The patients with bipolar disorder (the bipolar disorder group) were matched by age, sex, and registered general practice to 20 'controls' without recorded bipolar disorder (the control group). Annual episode incidence rates were estimated and odds ratios from conditional logistic regression models were reported for recorded health events before the index (diagnosis) date. Results: There were 2366 patients with incident bipolar disorder diagnoses and 47 138 matched control patients (median age 40 years and 60.4% female: Conclusion: Psychiatric diagnoses, psychotropic prescriptions, and health service use patterns might be signals of unreported bipolar disorder. Recognising these signals could prompt further investigation for undiagnosed significant psychopathology, leading to timely referral, assessment, and initiation of appropriate treatments.
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/BJGP.2022.0286
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Zs.B 576: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 100: Show issues

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Article ; Online: Non-fatal overdose risk associated with prescribing opioid agonists concurrently with other medication: Cohort study conducted using linked primary care, secondary care and mortality records.

Domzaridou, Eleni / Carr, Matthew J / Millar, Tim / Webb, Roger T / Ashcroft, Darren M

Addiction (Abingdon, England)

2023 Volume 118, Issue 12, Page(s) 2374–2383

Abstract: Background and aims: An apparently protective effect of opioid agonist treatment (OAT) on all-cause and cause-specific mortality risk has been widely reported. Non-fatal overdose (NFO) often precedes subsequent drug-poisoning deaths. We hypothesized ... ...

Abstract	Background and aims: An apparently protective effect of opioid agonist treatment (OAT) on all-cause and cause-specific mortality risk has been widely reported. Non-fatal overdose (NFO) often precedes subsequent drug-poisoning deaths. We hypothesized that benzodiazepines, gabapentinoids, antipsychotics, antidepressants, Z-drugs or opioids increase the NFO risk when co-prescribed with OAT. Design: We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases. The cohort was linked to Hospital Episode Statistics admitted patient care data (HES-APC), neighbourhood- and practice-level Index of Multiple Deprivation quintiles and mortality records from the Office for National Statistics. Setting: Primary care in England. Participants: We studied patients with opioid use disorder, aged 18-64 years, who were prescribed OAT (15155 methadone and 5743 buprenorphine recipients) between Jan 1, 1998, and Dec 31, 2017. Measurements: The main outcome examined was NFO risk during co-prescription of OAT with benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z-drugs or opioids. Overdose was defined according to International Classification of Diseases codes from the HES-APC data set. Negative binomial regression models were used to estimate weighted rate ratios (wRR) for NFO during co-prescription of OAT and benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z-drugs or opioids with periods of exclusive OAT usage. Findings: Among 20 898 patients observed over 83 856 person-years, we found an elevated overdose risk that resulted in hospital admission during co-prescription of OAT with benzodiazepines [wRR: 1.45; 95% confidence interval (CI) = 1.26-1.67], gabapentinoids (wRR = 2.22; 95% CI = 1.77-2.79), Z-drugs (wRR = 1.60; 95% CI = 1.31-1.96), antipsychotics (wRR = 1.85; 95% CI = 1.53-2.25) and opioids (wRR = 1.28; 95% CI = 1.02-1.60). The risk ratio for antidepressant co-prescriptions was below unity (wRR = 0.90; 95% CI = 0.79-1.02) but this result was not statistically significant. Conclusion: Elevated risk of non-fatal overdose among opioid agonist treatment recipients is associated with concurrent use of medication prescribed for other reasons.
MeSH term(s)	Humans ; Analgesics, Opioid/therapeutic use ; Cohort Studies ; Secondary Care ; Drug Overdose/drug therapy ; Benzodiazepines/therapeutic use ; Antidepressive Agents/therapeutic use ; Retrospective Studies
Chemical Substances	Analgesics, Opioid ; Benzodiazepines (12794-10-4) ; Antidepressive Agents
Language	English
Publishing date	2023-08-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1141051-6
ISSN	1360-0443 ; 0965-2140
ISSN (online)	1360-0443
ISSN	0965-2140
DOI	10.1111/add.16306
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