CALIBER Depression phenotype

person Phenotype Depression
person Type Disease or syndrome
person Data sources Primary care (CPRD), hospital admission data (HES)
person Clinical Terminologies Read, ICD-10, ICD-9, OPCS-4
person Valid event date range 01/01/1999 - 01/07/2016
person Sex Female/Male
person Agreed 23.11.2012 (Revision 2)
person Authors Julie George, Emily Herrett, Liam Smeeth, Harry Hemingway, Anoop Shah, Spiros Denaxas

Primary Care (incident)

In the Clinical Practice Research Datalink (CPRD, primary care data) we ascertained deoression cases by searching for Read terms related to a diagnosis.


Read codeRead termCALIBER category
E112100 Single major depressive episode, mild Mild-moderate
E112200 Single major depressive episode, moderate Mild-moderate
Eu32000 [X]Mild depressive episode Mild-moderate
Eu32100 [X]Moderate depressive episode Mild-moderate
Eu32400 [X]Mild depression Mild-moderate
Eu32500 [X]Major depression, mild Mild-moderate
Eu32600 [X]Major depression, moderately severe Mild-moderate
E112300 Single major depressive episode, severe, without psychosis Severe without psychotic symptoms
Eu32700 [X]Major depression, severe without psychotic symptoms Severe without psychotic symptoms
E11..12 Depressive psychoses Severe with psychotic symptoms
E112400 Single major depressive episode, severe, with psychosis Severe with psychotic symptoms
E130.00 Reactive depressive psychosis Severe with psychotic symptoms
E130.11 Psychotic reactive depression Severe with psychotic symptoms
Eu32311 [X]Single episode of major depression and psychotic symptoms Severe with psychotic symptoms
Eu32312 [X]Single episode of psychogenic depressive psychosis Severe with psychotic symptoms
Eu32313 [X]Single episode of psychotic depression Severe with psychotic symptoms
Eu32314 [X]Single episode of reactive depressive psychosis Severe with psychotic symptoms
Eu32800 [X]Major depression, severe with psychotic symptoms Severe with psychotic symptoms
Eu33311 [X]Endogenous depression with psychotic symptoms Severe with psychotic symptoms
E112.00 Single major depressive episode Single episode, severity unspecified
E112000 Single major depressive episode, unspecified Single episode, severity unspecified
E112500 Single major depressive episode, partial or unspec remission Single episode, severity unspecified
E112z00 Single major depressive episode NOS Single episode, severity unspecified
E11y200 Atypical depressive disorder Single episode, severity unspecified
E11z200 Masked depression Single episode, severity unspecified
E204.00 Neurotic depression reactive type Single episode, severity unspecified
E2B..00 Depressive disorder NEC Single episode, severity unspecified
Eu32.00 [X]Depressive episode Single episode, severity unspecified
Eu32.11 [X]Single episode of depressive reaction Single episode, severity unspecified
Eu32.12 [X]Single episode of psychogenic depression Single episode, severity unspecified
Eu32.13 [X]Single episode of reactive depression Single episode, severity unspecified
Eu32212 [X]Single episode major depression w'out psychotic symptoms Single episode, severity unspecified
Eu32213 [X]Single episode vital depression w'out psychotic symptoms Single episode, severity unspecified
Eu32y00 [X]Other depressive episodes Single episode, severity unspecified
Eu32y11 [X]Atypical depression Single episode, severity unspecified
Eu32y12 [X]Single episode of masked depression NOS Single episode, severity unspecified
Eu32z00 [X]Depressive episode, unspecified Single episode, severity unspecified
Eu32z11 [X]Depression NOS Single episode, severity unspecified
Eu32z12 [X]Depressive disorder NOS Single episode, severity unspecified
Eu32z13 [X]Prolonged single episode of reactive depression Single episode, severity unspecified
Eu32z14 [X] Reactive depression NOS Single episode, severity unspecified
Eu33z11 [X]Monopolar depression NOS Single episode, severity unspecified
Eu34111 [X]Depressive neurosis Single episode, severity unspecified
Eu34113 [X]Neurotic depression Single episode, severity unspecified
E112.12 Endogenous depression first episode Endogenous depression
E112.13 Endogenous depression first episode Endogenous depression
E112.14 Endogenous depression Endogenous depression
Eu33211 [X]Endogenous depression without psychotic symptoms Endogenous depression
E112.11 Agitated depression Agitated depression
E135.00 Agitated depression Agitated depression
Eu32211 [X]Single episode agitated depressn w'out psychotic symptoms Agitated depression
E211200 Depressive personality disorder Dysthymia
Eu34100 [X]Dysthymia Dysthymia
Eu34112 [X]Depressive personality disorder Dysthymia
E2B1.00 Chronic depression Chronic depression
E113100 Recurrent major depressive episodes, mild Recurrent mild-moderate
E113200 Recurrent major depressive episodes, moderate Recurrent mild-moderate
Eu33000 [X]Recurrent depressive disorder, current episode mild Recurrent mild-moderate
Eu33100 [X]Recurrent depressive disorder, current episode moderate Recurrent mild-moderate
E113300 Recurrent major depressive episodes, severe, no psychosis Recurrent severe without psychotic symptoms
Eu33200 [X]Recurr depress disorder cur epi severe without psyc sympt Recurrent severe without psychotic symptoms
E113400 Recurrent major depressive episodes, severe, with psychosis Recurrent severe with psychotic symptoms
Eu33300 [X]Recurrent depress disorder cur epi severe with psyc symp Recurrent severe with psychotic symptoms
Eu33313 [X]Recurr severe episodes/major depression+psychotic symptom Recurrent severe with psychotic symptoms
Eu33314 [X]Recurr severe episodes/psychogenic depressive psychosis Recurrent severe with psychotic symptoms
Eu33315 [X]Recurrent severe episodes of psychotic depression Recurrent severe with psychotic symptoms
Eu33316 [X]Recurrent severe episodes/reactive depressive psychosis Recurrent severe with psychotic symptoms
E113.00 Recurrent major depressive episode Recurrent severity unspecified
E113.11 Endogenous depression - recurrent Recurrent severity unspecified
E113000 Recurrent major depressive episodes, unspecified Recurrent severity unspecified
E113500 Recurrent major depressive episodes,partial/unspec remission Recurrent severity unspecified
E113600 Recurrent major depressive episodes, in full remission Recurrent severity unspecified
E113700 Recurrent depression Recurrent severity unspecified
E113z00 Recurrent major depressive episode NOS Recurrent severity unspecified
E118.00 Seasonal affective disorder Recurrent severity unspecified
Eu33.00 [X]Recurrent depressive disorder Recurrent severity unspecified
Eu33.11 [X]Recurrent episodes of depressive reaction Recurrent severity unspecified
Eu33.12 [X]Recurrent episodes of psychogenic depression Recurrent severity unspecified
Eu33.13 [X]Recurrent episodes of reactive depression Recurrent severity unspecified
Eu33.14 [X]Seasonal depressive disorder Recurrent severity unspecified
Eu33.15 [X]SAD - Seasonal affective disorder Recurrent severity unspecified
Eu33212 [X]Major depression, recurrent without psychotic symptoms Recurrent severity unspecified
Eu33214 [X]Vital depression, recurrent without psychotic symptoms Recurrent severity unspecified
Eu33400 [X]Recurrent depressive disorder, currently in remission Recurrent severity unspecified
Eu33y00 [X]Other recurrent depressive disorders Recurrent severity unspecified
Eu33z00 [X]Recurrent depressive disorder, unspecified Recurrent severity unspecified
Eu3y111 [X]Recurrent brief depressive episodes Recurrent severity unspecified
62T1.00 Puerperal depression Other or unspecified
E204.11 Postnatal depression Other or unspecified
E2B0.00 Postviral depression Other or unspecified
Eu53011 [X]Postnatal depression NOS Other or unspecified
Eu53012 [X]Postpartum depression NOS Other or unspecified
R007z13 [D]Postoperative depression Other or unspecified

Primary Care (prevalent)


Read codeRead termCALIBER category
1465.00 H/O: depression H/O depression
212S.00 Depression resolved H/O depression
E112600 Single major depressive episode, in full remission H/O depression

Depression referral


Read codeRead termCALIBER category
64R6.11 Child referral-school psychol. Referred to psychologist/psychotherapist
64R7.11 Child refer- clinical psychol. Referred to psychologist/psychotherapist
8H49.00 Psychiatric referral Referred to psychologist/psychotherapist
8H4D.00 Referral to psychogeriatrician Referred to psychologist/psychotherapist
8H4P.00 Referral to child psychiatrist Referred to psychologist/psychotherapist
8H78.00 Refer to counsellor Referred to psychologist/psychotherapist
8H7A.00 Refer to mental health worker Referred to psychologist/psychotherapist
8H7B.00 Refer to community psych.nurse Referred to psychologist/psychotherapist
8H7B.11 Refer to CPN Referred to psychologist/psychotherapist
8H7T.00 Refer to psychologist Referred to psychologist/psychotherapist
8HHK.00 Referral to bereavement counsellor Referred to psychologist/psychotherapist
8HHR.00 Referral to child and adolescent psychiatry service Referred to psychologist/psychotherapist
8HHT.00 Referral to psychotherapist Referred to psychologist/psychotherapist
8HHn.00 Referral to non NHS mental health community service Referred to psychologist/psychotherapist
8HHo.00 Referral to older age community mental health team Referred to psychologist/psychotherapist
8HHq.00 Referral for guided self-help for depression Referred to psychologist/psychotherapist
8HHr.00 Referral for mental health self-help literature Referred to psychologist/psychotherapist
8HHs.00 Referral to psychosis early intervention service Referred to psychologist/psychotherapist
8HHu.00 Referral to primary care mental health gateway worker Referred to psychologist/psychotherapist
8HHv.00 Referral to primary care mental health graduate worker Referred to psychologist/psychotherapist
8HJ3.00 Psychiatric self-referral Referred to psychologist/psychotherapist
8HK9.00 Psychiatric D.V. requested Referred to psychologist/psychotherapist
8HKC.00 Psychogeriatrics D.V. requestd Referred to psychologist/psychotherapist
8HTc.00 Referral to psychosexual clinic Referred to psychologist/psychotherapist
8HVO.00 Private referral to psychiatrist Referred to psychologist/psychotherapist
8HVS.00 Private referral to psychogeriatrician Referred to psychologist/psychotherapist
8Hc..00 Referral to mental health team Referred to psychologist/psychotherapist
8Hc0.00 Referral to community mental health team Referred to psychologist/psychotherapist
8Hc1.00 Referral to mental health crisis team Referred to psychologist/psychotherapist
8Hc2.00 Referral to primary care mental health team Referred to psychologist/psychotherapist
8Hj2.00 Referral to psycho-educational group Referred to psychologist/psychotherapist
8HkK.00 Referral to improving access to psychological therapies prog Referred to psychologist/psychotherapist
8Hl9.00 Referral to educational psychologist Referred to psychologist/psychotherapist
8HlB.00 Urgent referral to psychiatrist Referred to psychologist/psychotherapist
8HlD.00 Referral to forensic psychiatrist Referred to psychologist/psychotherapist
9N6h.00 Referral by mental health service Referred to psychologist/psychotherapist
9NN4.00 Has community mental health team key worker Referred to psychologist/psychotherapist
9NN7.00 Under care of mental health team Referred to psychologist/psychotherapist
9Nk6.00 Seen in mental health clinic Referred to psychologist/psychotherapist
ZL5B.00 Referral to psychiatrist Referred to psychologist/psychotherapist
ZL5B100 Referral to child and adolescent psychiatrist Referred to psychologist/psychotherapist
ZL5B111 Referral to child psychiatrist Referred to psychologist/psychotherapist
ZL5B200 Referral to forensic psychiatrist Referred to psychologist/psychotherapist
ZL5B300 Referral to liaison psychiatrist Referred to psychologist/psychotherapist
ZL5B400 Referral to rehabilitation psychiatrist Referred to psychologist/psychotherapist
ZL5B500 Referral to psychiatrist for mental handicap Referred to psychologist/psychotherapist
ZL62B00 Referral to nurse psychotherapist Referred to psychologist/psychotherapist
ZL62E00 Referral to psychiatric nurse Referred to psychologist/psychotherapist
ZL73.00 Referral to counsellor  Referred to psychologist/psychotherapist
ZL73.11 Refer to counsellor Referred to psychologist/psychotherapist
ZL73100 Referral to bereavement counsellor Referred to psychologist/psychotherapist
ZL73300 Referral to marriage guidance counsellor Referred to psychologist/psychotherapist
ZL73400 Referral to mental health counsellor Referred to psychologist/psychotherapist
ZL77.00 Referral to psychotherapist Referred to psychologist/psychotherapist
ZL78.00 Referral to psychologist Referred to psychologist/psychotherapist
ZL78.11 Refer to psychologist Referred to psychologist/psychotherapist
Read terms are hierarhically organized in top-level chapters i.e. chapter G....00 is related to Circulatory System Diseases and sub-headings i.e. heading G2...00 is related to Hypertensive Heart Disease while G3...00 is related to Ischaemic Heart Disease.

Secondary Care (incident and prevalent)

In Hospital Episode Statistics (HES, hospital admission data) we used ICD-10 terms (see below) for diagnosis when marked as the primary diagnosis i.e. the main condition treated or investigated during the relevant episode of healthcare. We used the date of admission to hospital as the date of the event.


ICD-10 codeICD-10 termCALIBER category
F320 Mild depressive episode Admitted with primary diagnosis of depression
F321 Moderate depressive episode Admitted with primary diagnosis of depression
F322 Severe depressive episode without psychotic symptoms Admitted with secondary diagnosis of depression
F323 Severe depressive episode with psychotic symptoms N/A
F328 Other depressive episodes N/A
F329 Depressive episode, unspecified N/A
F341 Dysthymia N/A
F331 Recurrent depressive disorder, current episode moderate N/A
F332 Recurrent depressive disorder, current episode severe without psychotic symptoms N/A
F333 Recurrent depressive disorder, current episode severe with psychotic symptoms N/A
F330 Recurrent depressive disorder, current episode mild N/A
F334 Recurrent depressive disorder, currently in remission N/A
F338 Other recurrent depressive disorders N/A
F339 Recurrent depressive disorder, unspecified N/A
F381 Other recurrent mood [affective] disorders N/A
_
Not applicable.

Combining evidence across sources to define and date phenotypes

New onset depression was defined as a record of a depression diagnosis and/or prescription of anti-depressant medications (selective serotonin reuptake inhibitor, monoamine-oxidase inhibitor, tricyclic, or other antidepressants) during this baseline period.
Risk factor Publication
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Risk factor Publication
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Daskalopoulou M et al. Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016. PMID: 27105076