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Mental illness may raise risk of breakthrough COVID-19, study says - The Hill

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  • Researchers at the University of California, San Francisco looked at data from 263,697 U.S. Department of Veterans Affairs patients who had completed their vaccines and had at least one COVID-19 test. 

  • Slightly more than 51 percent received at least one psychiatric diagnosis within the last five years and 14.8 percent experienced breakthrough COVID-19.

  • The breakthrough risk for patients over 65 was 24 percent higher for those with substance abuse disorder, 23 percent higher for those with psychotic disorders, 16 percent higher for bipolar disorder, 14 percent for adjustment disorder and 12 percent for anxiety.

People who are vaccinated against COVID-19 and have a history of certain mental illness may have an elevated risk of breakthrough infections, according to a new study.  

Researchers at the University of California, San Francisco looked at data from 263,697 U.S. Department of Veterans Affairs patients who had completed their vaccines and had at least one COVID-19 test. Slightly more than 51 percent received at least one psychiatric diagnosis within the last five years and 14.8 percent experienced a breakthrough COVID-19 infection.  

Patients over 65 with substance abuse disorder, psychotic disorders, bipolar disorder, adjustment disorder and anxiety had increased risks of up to 24 percent for a breakthrough COVID-19 infection while patients younger than 65 faced 11 percent greater risk of a breakthrough case than those without a history of mental illness.  

“Our research suggests that increased breakthrough infections in people with psychiatric disorders cannot be entirely explained by socio-demographic factors or pre-existing conditions,” said the study’s senior author Aoife O’Donovan. “It’s possible that immunity following vaccination wanes more quickly or more strongly for people with psychiatric disorders and/or they could have less protection to newer variants.” 

“Mental health is important to consider in conjunction with other risk factors,” she continued, “and some patients should be prioritized for boosters and other critical preventive efforts.” 

The breakthrough risk for patients over 65 was 24 percent higher for those with substance abuse, 23 percent higher for those with psychotic disorders, 16 percent higher for bipolar disorder, 14 percent for adjustment disorder and 12 percent for anxiety. 

The patients average age in the study was 66 and nearly 91 percent were male. Researchers adjusted the data for age, sex, race, ethnicity and vaccine type as well as for smoking and underlying conditions like obesity, diabetes, sleep apnea, cardiovascular, lung, kidney and liver diseases, HIV and cancer. 


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The study’s first author Kristen Nishimi attributed the higher incidence of breakthrough cases in adults over 65 to “decreased immunological response to vaccine that has been associated with some psychiatric disorders, which may be more substantial in older adults.”  

Nishimi added the older patients with psychiatric diagnoses could need more in-person healthcare, which “could increase their interactions with the health care system.”  

The study adds to a growing body of relationship between COVID-19 and mental health. A separate study released earlier this week by UCSF researchers concluded that nearly half of young adults experienced mental health symptoms during the pandemic’s second year.  

The teams’ findings showed a decline from a year prior. A study from the Centers for Disease Control and Prevention found 63 percent of young adults experienced symptoms of depression or anxiety in June 2020.


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Published on Apr. 15, 2022

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