Evidence map›Paper›PMID 42203437›Full record

ArticleBMJ mental health2026

Infections and severe mental illness: a population-based matched cohort study.

Sharon L Cadogan, Georgia R Gore-Langton, Kathryn E Mansfield, John Tazare, Seena Fazel, Ian J Douglas, Caroline Morton, Naaheed Mukadam, Charlotte Warren-Gash

Abstract read
In one paragraph

Article in BMJ mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sharon L Cadogan *Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Georgia R Gore-Langton *Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Kathryn E MansfieldSchool of Health and Care Sciences, University of Lincoln, Lincoln, UK.ORCID http://orcid.org/0000-0002-2551-410X
John TazareFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-7194-2615
Seena FazelDepartment of Psychiatry, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-5383-5365
Ian J DouglasFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Caroline MortonFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Naaheed MukadamDivision of Psychiatry, University College London, London, UK.
Charlotte Warren-GashFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK Charlotte.Warren-Gash1@lshtm.ac.uk.ORCID http://orcid.org/0000-0003-4524-3180

Funding

Wellcome Trust 225868/Z/22/Z
6 · The paper itself

Abstract

backgroundIt is unclear whether acute infections associated with short-term systemic inflammation influence the risk of severe mental illness (SMI).

objectiveTo investigate relationships between acute infections and incident SMI using electronic health records from the UK.

methodsUsing data from the Clinical Practice Research Datalink Aurum (1 January 2007 to 15 June 2024), we conducted six matched cohort studies. Adults (≥18 years) with gastroenteritis (GE), lower respiratory tract infection (LRTI), skin and soft tissue infection (SSTI), urinary tract infection (UTI), sepsis and meningitis/encephalitis (positive control exposure) recorded in primary care were matched with up to five individuals without infection on age, sex and practice in calendar date order and followed for incident SMI (schizophrenia, bipolar disorder, other psychoses). We estimated HRs for SMI comparing those with and without each infection using Cox regression, stratified by match set, adjusting for potential confounders (deprivation, Charlson Comorbidity Index, alcohol, smoking, body mass index and ethnicity).

findingsOur six study cohorts ranged from 2 089 168 adults (391 773 with SSTI, 1 697 395 without) to 106 155 (17 860 with meningitis/encephalitis, 88 295 without). Median follow-up ranged from 4.1 years (IQR 1.9-6.9) in the sepsis cohort to 5.7 years (IQR 2.6-9.8) in the meningitis/encephalitis cohort. After adjustment, each infection was associated with increased SMI risk: SSTI, HR 1.16 (95% CI 1.08 to 1.24); LRTI, 1.28 (95% CI 1.20 to 1.38); UTI, 1.44 (95% CI 1.31 to 1.58); GE, 1.53 (95% CI 1.42 to 1.65); sepsis, 1.69 (95% CI 1.52 to 1.88); and meningitis/encephalitis, 3.36 (95% CI 2.61 to 4.32).

conclusionOur findings suggest SMI risk is higher among adults with a range of acute infections compared with those without, with higher risks for the more severe infections meningitis/encephalitis and sepsis. CLINICAL IMPLICATIONS: Providing timely infection treatment, targeted mental health support following severe infections, and where appropriate offering relevant vaccinations, may limit SMI risk.

Indexed as

InfectionsMental DisordersAdultCohort StudiesFemaleHumansMaleMiddle AgedRespiratory Tract InfectionsSepsisUnited KingdomUrinary Tract InfectionsBipolar and Related DisordersSchizophreniaSchizophrenia Spectrum and Other Psychotic Disorders

Identifiers

PMID42203437
PMCPMC13218188

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.