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Using UK Biobank data, three cohorts were constructed: SARS-CoV-2 infection (<jats:italic>n<\/jats:italic>\u2009=\u200926,101), contemporary control with no evidence of infection (<jats:italic>n<\/jats:italic>\u2009=\u2009380,337) and historical control predating the pandemic (<jats:italic>n<\/jats:italic>\u2009=\u2009390,621). Compared with contemporary controls, infected participants had higher subsequent risks of incident mental health at 1\u2009year (hazard ratio (HR): 1.54, 95% CI 1.42\u20131.67; <jats:italic>P<\/jats:italic>\u2009=\u20091.70\u2009\u00d7\u200910<jats:sup>\u221224<\/jats:sup>; difference in incidence rate: 27.36, 95% CI 21.16\u201334.10 per 1,000 person-years), including psychotic, mood, anxiety, alcohol use and sleep disorders, and prescriptions for antipsychotics, antidepressants, benzodiazepines, mood stabilizers and opioids. Risks were higher for hospitalized individuals (2.17, 1.70\u20132.78; <jats:italic>P<\/jats:italic>\u2009=\u20095.80\u2009\u00d7\u200910<jats:sup>\u221210<\/jats:sup>) than those not hospitalized (1.41, 1.30\u20131.53; <jats:italic>P<\/jats:italic>\u2009=\u20091.46\u2009\u00d7\u200910<jats:sup>\u221216<\/jats:sup>), and were reduced in fully vaccinated people (0.97, 0.80\u20131.19; <jats:italic>P<\/jats:italic>\u2009=\u20090.799) compared with non-vaccinated or partially vaccinated individuals (1.64, 1.49\u20131.79; <jats:italic>P<\/jats:italic>\u2009=\u20094.95\u2009\u00d7\u200910<jats:sup>\u221226<\/jats:sup>). Breakthrough infections showed similar risk of psychiatric diagnosis (0.91, 0.78\u20131.07; <jats:italic>P<\/jats:italic>\u2009=\u20090.278) but increased prescription risk (1.42, 1.00\u20132.02; <jats:italic>P<\/jats:italic>\u2009=\u20090.053) compared with uninfected controls. Early identification and treatment of psychiatric disorders in COVID-19 survivors, especially those severely affected or unvaccinated, should be a priority in the management of long COVID. With the accumulation of breakthrough infections in the post-pandemic era, the findings highlight the need for continued optimization of strategies to foster resilience and prevent escalation of subclinical mental health symptoms to severe disorders.<\/jats:p>","DOI":"10.1038\/s41562-024-01853-4","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T11:01:57Z","timestamp":1711018917000},"page":"1076-1087","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Long-term risk of psychiatric disorder and psychotropic prescription after SARS-CoV-2 infection among UK general population"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0923-1441","authenticated-orcid":false,"given":"Yunhe","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-024X","authenticated-orcid":false,"given":"Binbin","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0040-0042","authenticated-orcid":false,"given":"Junqing","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemente","family":"Garcia-Rizo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Prieto-Alhambra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"1853_CR1","unstructured":"WHO COVID-19 Dashboard (World Health Organization, 2024)."},{"key":"1853_CR2","doi-asserted-by":"publisher","first-page":"n1648","DOI":"10.1136\/bmj.n1648","volume":"374","author":"H Crook","year":"2021","unstructured":"Crook, H., Raza, S., Nowell, J., Young, M. & Edison, P. 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