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COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People

Venexia M. Walker, Praveetha Patalay, Jose Ignacio Cuitun Coronado, Rachel Denholm, Harriet Forbes, Jean Stafford, Bettina Moltrecht, Tom Palmer, Alex Walker, Ellen J. Thompson, Kurt Taylor, Genevieve Cezard, Elsie M. F. Horne, Yinghui Wei, Marwa Al Arab, Rochelle Knight, Louis Fisher, Jon Massey, Simon Davy, Amir Mehrkar, Seb Bacon, Ben Goldacre, Angela Wood, Nishi Chaturvedi, John Macleod, Ann John, Jonathan A. C. Sterne, (Longitudinal Health and Wellbeing COVID-19 National Core Study), Agnieszka Lemanska, Alex Kwong , Alexia Sampri, Alicja Rapala, Alisia Carnemolla, Alun Hughes, Amelia Green, Amos Folarin, Amy Roberts , Ana Goncalves Soares, Andrew Steptoe, Andrew Wong, Andy Boyd, Andy Gibson, Anika Knueppel , Anoop Shah, Archie Campbell, Arun Kanagaratnam, Arun Karthikeyan Suseeladevi , Bang Zheng , Betty Raman, Bo Hou, Bozena Wielgoszewska, Brain Mackenna , Callum Stewart, Chao Fang, Charis Bridger-Staatz, Charlotte Booth , Chelsea Beckford, Chloe Park, Claire Steves, Colm Andrews, Daniel McCartney , Daniel Kopasker , Diane Foster, Dominik Piehlmaier, Dylan Williams, Edward Parker, Elena Rafeti , Elena Lukaschuk , Elizabeth Tunnicliffe , Ellena Badrick, Emily Herrett, Emma L Turner, Eoin McElroy, Fatima Almaghrabi , Felix Greaves, Fintan McArdle, Fiona Glen, Francisco Perez-Reche, Gareth Griffith, George Ploubidis, Gillian Santorelli, Giorgio Di Gessa, Hannah Woodward, Helen Curtis  , Annie Herbert, Ian Douglas, Jacqui Oakley, James M Wild, Jane Maddock, JD Carpentieri, Jess Morley, Jingmin Zhu, John Tazare, John Wright, John Kellas, Jonathan Kennedy, Kate Northstone, Kate Tilling, Kate  Mansfield, Katharine M Evans, Kathryn Mansfield , Kathryn Willan, Kevin Wang, Kirsteen C Campbell, Kishan Patel, Laura Fox, Laura Sheard, Laura C Saunders, Laurie Tomlinson, Lee Hamill Howes, Liam Smeeth , Lidia Nigrelli, Linda Nab, Lisa Hopcroft , Lizzie Huntley, Louise Jones, Lucy Finnigan , Lucy Teece, Mark Green , Matthew Crane, Maxim Freydin, Michael Parker, Michael Green, Milla Kibble, Nathan Cheetham, Nicholas Timpson, Olivia Hamilton, Paola Zaninotto, Paz Garcia, Peter Jezzard, Rebecca Whitehorn, Rebecca Rhead, Renin Toms, Richard Thomas, Richard Silverwood, Richard Dobson, Robert Willans, Robin Flaig , Rosie McEachan, Ruth Mitchell, Ruth Bowyer, Ruth Costello, Sam Parsons, Samantha Berman, Samantha Ip, Sarah Baz, Scott Walker, Shah Syed Ahmar, Richard Shaw, Sheikh Aziz, Sinead Langan, Sinead Brophy , Spiros Denaxas, Stefan Neubauer , Stefan Piechnik , Stela McLachlan, Stephen Smith , Steve Sharp, Teri North , Theocharis Kromydas , Thomas Cowling, Tiffany Yang, Tom Bolton , Vanessa Ferreira , Vittal Katikireddi , Viyaasan Mahalingasivam, Wels Jacques, William Hulme, Yatharth Ranjan, Zeena-Britt Sanders , Ann John Orcid Logo

JAMA Psychiatry

Swansea University Author: Ann John Orcid Logo

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DOI (Published version): 10.1001/jamapsychiatry.2024.2339

Abstract

Importance Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.Objective To determine which me...

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Published in: JAMA Psychiatry
ISSN: 2168-622X
Published: American Medical Association (AMA) 2024
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa67602
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>67602</id><entry>2024-09-06</entry><title>COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People</title><swanseaauthors><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-09-06</date><deptcode>MEDS</deptcode><abstract>Importance Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.Objective To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population.Design, Setting, and Participants This study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024.Exposure Confirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry.Main Outcomes and Measures Adjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide.Results The largest cohort, the pre–vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre–vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre–vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19.Conclusions and Relevance In this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health.</abstract><type>Journal Article</type><journal>JAMA Psychiatry</journal><volume>0</volume><journalNumber/><paginationStart/><paginationEnd/><publisher>American Medical Association (AMA)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2168-622X</issnPrint><issnElectronic/><keywords/><publishedDay>21</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-08-21</publishedDate><doi>10.1001/jamapsychiatry.2024.2339</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was supported by the COVID-19 Longitudinal Health and Wellbeing National Core Study, which is funded by the Medical Research Council (MRC) (MC_PC_20059) and the National Institute for Health and Care Research (NIHR) (COV-LT-0009). Dr V. Walker is also supported by the Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol (MC_UU_00032/03). Dr Wei was supported by a UK Research and Innovation (UKRI) MRC (MC/W021358/1) and received funding from UKRI Engineering and Physical Sciences Research Council impact acceleration account (EP/X525789/1). Dr Mehrkar received funding from the Bennett Foundation, Wellcome Trust, NIHR Oxford Biomedical Research Centre, NIHR Applied Research Collaboration Oxford and Thames Valley, and the Mohn-Westlake Foundation. The OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z) and the MRC (MR/V015737/1, MC_PC_20059, and MR/W016729/ 1). In addition, development of OpenSAFELY has been funded by the Longitudinal Health and Wellbeing strand of the National Core Studies programme (MC_PC_20030: MC_PC_20059), the NIHR-funded CONVALESCENCE programme (COV-LT-0009), the NIHR (NIHR135559 and COV-LT2-0073), and the Data and Connectivity National Core Study funded by UK Research and Innovation (MC_PC_20058) and Health Data Research UK (HDRUK2021.000)</funders><projectreference/><lastEdited>2024-10-25T13:00:20.8800301</lastEdited><Created>2024-09-06T13:40:17.8350600</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Venexia M.</firstname><surname>Walker</surname><order>1</order></author><author><firstname>Praveetha</firstname><surname>Patalay</surname><order>2</order></author><author><firstname>Jose Ignacio Cuitun</firstname><surname>Coronado</surname><order>3</order></author><author><firstname>Rachel</firstname><surname>Denholm</surname><order>4</order></author><author><firstname>Harriet</firstname><surname>Forbes</surname><order>5</order></author><author><firstname>Jean</firstname><surname>Stafford</surname><order>6</order></author><author><firstname>Bettina</firstname><surname>Moltrecht</surname><order>7</order></author><author><firstname>Tom</firstname><surname>Palmer</surname><order>8</order></author><author><firstname>Alex</firstname><surname>Walker</surname><order>9</order></author><author><firstname>Ellen J.</firstname><surname>Thompson</surname><order>10</order></author><author><firstname>Kurt</firstname><surname>Taylor</surname><order>11</order></author><author><firstname>Genevieve</firstname><surname>Cezard</surname><order>12</order></author><author><firstname>Elsie M. F.</firstname><surname>Horne</surname><order>13</order></author><author><firstname>Yinghui</firstname><surname>Wei</surname><order>14</order></author><author><firstname>Marwa Al</firstname><surname>Arab</surname><order>15</order></author><author><firstname>Rochelle</firstname><surname>Knight</surname><order>16</order></author><author><firstname>Louis</firstname><surname>Fisher</surname><order>17</order></author><author><firstname>Jon</firstname><surname>Massey</surname><order>18</order></author><author><firstname>Simon</firstname><surname>Davy</surname><order>19</order></author><author><firstname>Amir</firstname><surname>Mehrkar</surname><order>20</order></author><author><firstname>Seb</firstname><surname>Bacon</surname><order>21</order></author><author><firstname>Ben</firstname><surname>Goldacre</surname><order>22</order></author><author><firstname>Angela</firstname><surname>Wood</surname><order>23</order></author><author><firstname>Nishi</firstname><surname>Chaturvedi</surname><order>24</order></author><author><firstname>John</firstname><surname>Macleod</surname><order>25</order></author><author><firstname>Ann</firstname><surname>John</surname><order>26</order></author><author><firstname>Jonathan A. 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Syed</firstname><surname>Ahmar</surname><order>148</order></author><author><firstname>Richard</firstname><surname>Shaw</surname><order>149</order></author><author><firstname>Sheikh</firstname><surname>Aziz</surname><order>150</order></author><author><firstname>Sinead</firstname><surname>Langan</surname><order>151</order></author><author><firstname>Sinead</firstname><surname>Brophy </surname><order>152</order></author><author><firstname>Spiros</firstname><surname>Denaxas</surname><order>153</order></author><author><firstname>Stefan</firstname><surname>Neubauer </surname><order>154</order></author><author><firstname>Stefan</firstname><surname>Piechnik </surname><order>155</order></author><author><firstname>Stela</firstname><surname>McLachlan</surname><order>156</order></author><author><firstname>Stephen</firstname><surname>Smith </surname><order>157</order></author><author><firstname>Steve</firstname><surname>Sharp</surname><order>158</order></author><author><firstname>Teri</firstname><surname>North </surname><order>159</order></author><author><firstname>Theocharis</firstname><surname>Kromydas </surname><order>160</order></author><author><firstname>Thomas</firstname><surname>Cowling</surname><order>161</order></author><author><firstname>Tiffany</firstname><surname>Yang</surname><order>162</order></author><author><firstname>Tom</firstname><surname>Bolton </surname><order>163</order></author><author><firstname>Vanessa</firstname><surname>Ferreira </surname><order>164</order></author><author><firstname>Vittal</firstname><surname>Katikireddi </surname><order>165</order></author><author><firstname>Viyaasan</firstname><surname>Mahalingasivam</surname><order>166</order></author><author><firstname>Wels</firstname><surname>Jacques</surname><order>167</order></author><author><firstname>William</firstname><surname>Hulme</surname><order>168</order></author><author><firstname>Yatharth</firstname><surname>Ranjan</surname><order>169</order></author><author><firstname>Zeena-Britt</firstname><surname>Sanders </surname><order>170</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>171</order></author></authors><documents><document><filename>67602__31275__6f5af2c9a33c4ac09359a0d6074d6bb8.pdf</filename><originalFilename>jamapsychiatry_walker_2024_oi_240050_1723059057.73059.pdf</originalFilename><uploaded>2024-09-06T14:27:02.9198329</uploaded><type>Output</type><contentLength>477871</contentLength><contentType>application/pdf</contentType><version>Version 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spelling v2 67602 2024-09-06 COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2024-09-06 MEDS Importance Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.Objective To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population.Design, Setting, and Participants This study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024.Exposure Confirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry.Main Outcomes and Measures Adjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide.Results The largest cohort, the pre–vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre–vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre–vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19.Conclusions and Relevance In this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health. Journal Article JAMA Psychiatry 0 American Medical Association (AMA) 2168-622X 21 8 2024 2024-08-21 10.1001/jamapsychiatry.2024.2339 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This work was supported by the COVID-19 Longitudinal Health and Wellbeing National Core Study, which is funded by the Medical Research Council (MRC) (MC_PC_20059) and the National Institute for Health and Care Research (NIHR) (COV-LT-0009). Dr V. Walker is also supported by the Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol (MC_UU_00032/03). Dr Wei was supported by a UK Research and Innovation (UKRI) MRC (MC/W021358/1) and received funding from UKRI Engineering and Physical Sciences Research Council impact acceleration account (EP/X525789/1). Dr Mehrkar received funding from the Bennett Foundation, Wellcome Trust, NIHR Oxford Biomedical Research Centre, NIHR Applied Research Collaboration Oxford and Thames Valley, and the Mohn-Westlake Foundation. The OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z) and the MRC (MR/V015737/1, MC_PC_20059, and MR/W016729/ 1). In addition, development of OpenSAFELY has been funded by the Longitudinal Health and Wellbeing strand of the National Core Studies programme (MC_PC_20030: MC_PC_20059), the NIHR-funded CONVALESCENCE programme (COV-LT-0009), the NIHR (NIHR135559 and COV-LT2-0073), and the Data and Connectivity National Core Study funded by UK Research and Innovation (MC_PC_20058) and Health Data Research UK (HDRUK2021.000) 2024-10-25T13:00:20.8800301 2024-09-06T13:40:17.8350600 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Venexia M. Walker 1 Praveetha Patalay 2 Jose Ignacio Cuitun Coronado 3 Rachel Denholm 4 Harriet Forbes 5 Jean Stafford 6 Bettina Moltrecht 7 Tom Palmer 8 Alex Walker 9 Ellen J. Thompson 10 Kurt Taylor 11 Genevieve Cezard 12 Elsie M. F. Horne 13 Yinghui Wei 14 Marwa Al Arab 15 Rochelle Knight 16 Louis Fisher 17 Jon Massey 18 Simon Davy 19 Amir Mehrkar 20 Seb Bacon 21 Ben Goldacre 22 Angela Wood 23 Nishi Chaturvedi 24 John Macleod 25 Ann John 26 Jonathan A. C. Sterne 27 (Longitudinal Health and Wellbeing COVID-19 National Core Study) 28 Agnieszka Lemanska 29 Alex Kwong  30 Alexia Sampri 31 Alicja Rapala 32 Alisia Carnemolla 33 Alun Hughes 34 Amelia Green 35 Amos Folarin 36 Amy Roberts  37 Ana Goncalves Soares 38 Andrew Steptoe 39 Andrew Wong 40 Andy Boyd 41 Andy Gibson 42 Anika Knueppel  43 Anoop Shah 44 Archie Campbell 45 Arun Kanagaratnam 46 Arun Karthikeyan Suseeladevi  47 Bang Zheng  48 Betty Raman 49 Bo Hou 50 Bozena Wielgoszewska 51 Brain Mackenna  52 Callum Stewart 53 Chao Fang 54 Charis Bridger-Staatz 55 Charlotte Booth  56 Chelsea Beckford 57 Chloe Park 58 Claire Steves 59 Colm Andrews 60 Daniel McCartney  61 Daniel Kopasker  62 Diane Foster 63 Dominik Piehlmaier 64 Dylan Williams 65 Edward Parker 66 Elena Rafeti  67 Elena Lukaschuk  68 Elizabeth Tunnicliffe  69 Ellena Badrick 70 Emily Herrett 71 Emma L Turner 72 Eoin McElroy 73 Fatima Almaghrabi  74 Felix Greaves 75 Fintan McArdle 76 Fiona Glen 77 Francisco Perez-Reche 78 Gareth Griffith 79 George Ploubidis 80 Gillian Santorelli 81 Giorgio Di Gessa 82 Hannah Woodward 83 Helen Curtis   84 Annie Herbert 85 Ian Douglas 86 Jacqui Oakley 87 James M Wild 88 Jane Maddock 89 JD Carpentieri 90 Jess Morley 91 Jingmin Zhu 92 John Tazare 93 John Wright 94 John Kellas 95 Jonathan Kennedy 96 Kate Northstone 97 Kate Tilling 98 Kate  Mansfield 99 Katharine M Evans 100 Kathryn Mansfield  101 Kathryn Willan 102 Kevin Wang 103 Kirsteen C Campbell 104 Kishan Patel 105 Laura Fox 106 Laura Sheard 107 Laura C Saunders 108 Laurie Tomlinson 109 Lee Hamill Howes 110 Liam Smeeth  111 Lidia Nigrelli 112 Linda Nab 113 Lisa Hopcroft  114 Lizzie Huntley 115 Louise Jones 116 Lucy Finnigan  117 Lucy Teece 118 Mark Green  119 Matthew Crane 120 Maxim Freydin 121 Michael Parker 122 Michael Green 123 Milla Kibble 124 Nathan Cheetham 125 Nicholas Timpson 126 Olivia Hamilton 127 Paola Zaninotto 128 Paz Garcia 129 Peter Jezzard 130 Rebecca Whitehorn 131 Rebecca Rhead 132 Renin Toms 133 Richard Thomas 134 Richard Silverwood 135 Richard Dobson 136 Robert Willans 137 Robin Flaig  138 Rosie McEachan 139 Ruth Mitchell 140 Ruth Bowyer 141 Ruth Costello 142 Sam Parsons 143 Samantha Berman 144 Samantha Ip 145 Sarah Baz 146 Scott Walker 147 Shah Syed Ahmar 148 Richard Shaw 149 Sheikh Aziz 150 Sinead Langan 151 Sinead Brophy  152 Spiros Denaxas 153 Stefan Neubauer  154 Stefan Piechnik  155 Stela McLachlan 156 Stephen Smith  157 Steve Sharp 158 Teri North  159 Theocharis Kromydas  160 Thomas Cowling 161 Tiffany Yang 162 Tom Bolton  163 Vanessa Ferreira  164 Vittal Katikireddi  165 Viyaasan Mahalingasivam 166 Wels Jacques 167 William Hulme 168 Yatharth Ranjan 169 Zeena-Britt Sanders  170 Ann John 0000-0002-5657-6995 171 67602__31275__6f5af2c9a33c4ac09359a0d6074d6bb8.pdf jamapsychiatry_walker_2024_oi_240050_1723059057.73059.pdf 2024-09-06T14:27:02.9198329 Output 477871 application/pdf Version of Record true This is an open access article distributed under the terms of the CC-BY License. true eng https://jamanetwork.com/pages/cc-by-license-permissions?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jamapsychiatry.2024.2339
title COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
spellingShingle COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
Ann John
title_short COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
title_full COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
title_fullStr COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
title_full_unstemmed COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
title_sort COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
author_id_str_mv ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Ann John
author2 Venexia M. Walker
Praveetha Patalay
Jose Ignacio Cuitun Coronado
Rachel Denholm
Harriet Forbes
Jean Stafford
Bettina Moltrecht
Tom Palmer
Alex Walker
Ellen J. Thompson
Kurt Taylor
Genevieve Cezard
Elsie M. F. Horne
Yinghui Wei
Marwa Al Arab
Rochelle Knight
Louis Fisher
Jon Massey
Simon Davy
Amir Mehrkar
Seb Bacon
Ben Goldacre
Angela Wood
Nishi Chaturvedi
John Macleod
Ann John
Jonathan A. C. Sterne
(Longitudinal Health and Wellbeing COVID-19 National Core Study)
Agnieszka Lemanska
Alex Kwong 
Alexia Sampri
Alicja Rapala
Alisia Carnemolla
Alun Hughes
Amelia Green
Amos Folarin
Amy Roberts 
Ana Goncalves Soares
Andrew Steptoe
Andrew Wong
Andy Boyd
Andy Gibson
Anika Knueppel 
Anoop Shah
Archie Campbell
Arun Kanagaratnam
Arun Karthikeyan Suseeladevi 
Bang Zheng 
Betty Raman
Bo Hou
Bozena Wielgoszewska
Brain Mackenna 
Callum Stewart
Chao Fang
Charis Bridger-Staatz
Charlotte Booth 
Chelsea Beckford
Chloe Park
Claire Steves
Colm Andrews
Daniel McCartney 
Daniel Kopasker 
Diane Foster
Dominik Piehlmaier
Dylan Williams
Edward Parker
Elena Rafeti 
Elena Lukaschuk 
Elizabeth Tunnicliffe 
Ellena Badrick
Emily Herrett
Emma L Turner
Eoin McElroy
Fatima Almaghrabi 
Felix Greaves
Fintan McArdle
Fiona Glen
Francisco Perez-Reche
Gareth Griffith
George Ploubidis
Gillian Santorelli
Giorgio Di Gessa
Hannah Woodward
Helen Curtis  
Annie Herbert
Ian Douglas
Jacqui Oakley
James M Wild
Jane Maddock
JD Carpentieri
Jess Morley
Jingmin Zhu
John Tazare
John Wright
John Kellas
Jonathan Kennedy
Kate Northstone
Kate Tilling
Kate  Mansfield
Katharine M Evans
Kathryn Mansfield 
Kathryn Willan
Kevin Wang
Kirsteen C Campbell
Kishan Patel
Laura Fox
Laura Sheard
Laura C Saunders
Laurie Tomlinson
Lee Hamill Howes
Liam Smeeth 
Lidia Nigrelli
Linda Nab
Lisa Hopcroft 
Lizzie Huntley
Louise Jones
Lucy Finnigan 
Lucy Teece
Mark Green 
Matthew Crane
Maxim Freydin
Michael Parker
Michael Green
Milla Kibble
Nathan Cheetham
Nicholas Timpson
Olivia Hamilton
Paola Zaninotto
Paz Garcia
Peter Jezzard
Rebecca Whitehorn
Rebecca Rhead
Renin Toms
Richard Thomas
Richard Silverwood
Richard Dobson
Robert Willans
Robin Flaig 
Rosie McEachan
Ruth Mitchell
Ruth Bowyer
Ruth Costello
Sam Parsons
Samantha Berman
Samantha Ip
Sarah Baz
Scott Walker
Shah Syed Ahmar
Richard Shaw
Sheikh Aziz
Sinead Langan
Sinead Brophy 
Spiros Denaxas
Stefan Neubauer 
Stefan Piechnik 
Stela McLachlan
Stephen Smith 
Steve Sharp
Teri North 
Theocharis Kromydas 
Thomas Cowling
Tiffany Yang
Tom Bolton 
Vanessa Ferreira 
Vittal Katikireddi 
Viyaasan Mahalingasivam
Wels Jacques
William Hulme
Yatharth Ranjan
Zeena-Britt Sanders 
Ann John
format Journal article
container_title JAMA Psychiatry
container_volume 0
publishDate 2024
institution Swansea University
issn 2168-622X
doi_str_mv 10.1001/jamapsychiatry.2024.2339
publisher American Medical Association (AMA)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Importance Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.Objective To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population.Design, Setting, and Participants This study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024.Exposure Confirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry.Main Outcomes and Measures Adjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide.Results The largest cohort, the pre–vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre–vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre–vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19.Conclusions and Relevance In this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health.
published_date 2024-08-21T13:00:20Z
_version_ 1813887183910600704
score 11.03502

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