Mental disorders associated with COVID-19 breakthrough infection in vaccinated VA patients
Mental disorders associated with COVID-19 breakthrough infection in vaccinated VA patients

Mental disorders associated with COVID-19 breakthrough infection in vaccinated VA patients

April 18, 2022

1 min read


Information: Nishimi reports having received grants from the Department of Veterans Affairs Office of Academic Affiliations during the course of the investigation. Please see the survey for all other authors’ relevant financial information.


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Diagnoses of psychiatric disorders were associated with an increased incidence of COVID-19 breakthrough infection in VA patients, with the strongest correlations found in elderly patients, according to a study published in JAMA network open.

“Prior to the widespread availability of vaccinations, individuals with psychiatric disorders were at increased risk of contracting COVID-19 and of experiencing serious comorbidities, including hospitalization and death.” Christian NishimiPhD, from the Department of Psychiatry and the Weill Institute for Neurosciences at the University of California, San Francisco, and colleagues wrote.


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“There is a need to identify whether psychiatric disorders increase the risk of SARS-CoV-2 breakthrough infections after vaccination, so that targeted preventive interventions can be used in this population, if warranted.”

Nishimi and colleagues wanted to evaluate whether previous diagnoses of psychiatric disorders have anything to do with increased incidence of COVID-19 breakthrough infection among those who are fully vaccinated.

The retrospective cohort study included data from health records for 263,697 Veterans Affairs patients (90.8% men; mean age 66.2 years) from February 20, 2020 to November 16, 2021. All participants recorded at least one COVID-19 test in their electronic health records, had no prior infection before vaccination and had completed a full vaccination at least 2 weeks or more before.

Data were analyzed to include psychiatric disorder diagnoses within the last 5 years, including depressive, post-traumatic stress, anxiety, adjustment, alcohol / drug use, bipolar, psychotic, ADHD, dissociative, and eating disorders.

Results revealed that 135,481 (51.4%) of participants presented with at least one psychiatric disorder diagnosis, in which 39,109 (14.8%) developed a breakthrough infection.

Most specific psychiatric disorder diagnoses were associated with an increased incidence of breakthrough infection, with the highest RR observed for adaptive disorders (aRR, 1.13; 95% CI, 1.10-1.16) and substance abuse disorders (aRR, 1.16; 95 % CI, 1.12 -1.21) in fully customized models.

Data also showed when classifying the above for persons under or over 65 years of age that there were correlations between psychiatric diagnoses and breakthrough infection in both groups, but were stronger when adjusting for medical comorbidities and smoking among elderly patients.

“Psychiatric disorders remained significantly associated with incident breakthrough infections in addition to sociodemographic and medical factors, suggesting that mental health is important to consider in relation to other risk factors,” Nishimi said.

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