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Infections and severe mental illness: a population-based matched cohort study
Sharon L Cadogan1, Georgia R Gore-Langton1, Kathryn E Mansfield2
1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
BMJ Mental Health
|May 27, 2026
Summary
Acute infections increase the risk of severe mental illness (SMI). Even common infections like skin or respiratory issues raise SMI risk, with severe infections like sepsis posing the highest risk.
Area of Science:
- Epidemiology
- Infectious Diseases
- Psychiatry
Background:
- The link between acute infections and severe mental illness (SMI) remains unclear.
- Systemic inflammation from infections may influence mental health outcomes.
Purpose of the Study:
- To investigate the association between acute infections and the incidence of SMI.
- Utilized UK electronic health records for a large-scale cohort study.
Main Methods:
- Six matched cohort studies were conducted using the Clinical Practice Research Datalink Aurum.
- Adults with specific infections (gastroenteritis, LRTI, SSTI, UTI, sepsis, meningitis/encephalitis) were compared to uninfected individuals.
- Cox regression models estimated hazard ratios (HRs) for incident SMI, adjusting for confounders.
Main Results:
- Each infection studied was associated with an increased risk of SMI.
- Hazard ratios ranged from 1.16 for skin and soft tissue infections (SSTI) to 3.36 for meningitis/encephalitis.
- More severe infections, such as sepsis and meningitis/encephalitis, showed substantially higher SMI risks.
Conclusions:
- Acute infections are linked to a higher risk of developing severe mental illness.
- Interventions like prompt infection treatment, targeted mental health support post-infection, and vaccinations may mitigate SMI risk.
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