Background: The impact of SARS-CoV-2 infection on mental health is debated. The aim of this study was to determine if SARS-CoV-2 infection is associated with increased risk of psychiatric admissions and de-novo prescription of psychoactive medication.

Methods: Adults (? 18 years) were assigned to either control or SARS-CoV-2 group based on polymerase chain reaction (PCR)-tests between 1 January 2020 and 27 November 2021. Positive subjects were matched 1:5 to control subjects by propensity score. Incidence rate ratios (IRR) were calculated. Adjusted Cox regression was applied to the unmatched population with SARS-CoV-2 infection as a time-dependent covariate. Follow-up time was 12 months or until end of study.

Results: 4,585,083 adults were included. 342,084 had a PCR confirmed SARS-CoV-2 infection. Infected subjects were matched 1:5 with 1,697,680 controls. The IRR for psychiatric admission was 0.85 in the matched population (95% CI: 0.79?0.91, p < 0.001). In the unmatched population the adjusted hazard ratio (HR) for psychiatric admission was 0.79 (95% CI: 0.75?0.82, p < 0.001). There was a slight association between SARS-CoV-2 infection and de-novo prescription of psychoactive medication in both the matched (IRR 1.06, 95% CI: 1.02?1.11, p < 0.01) and unmatched population (HR 1.31, 95% CI: 1.28?1.34, p < 0.001).

Conclusions: We found a signal of increased use of psychoactive medication, specifically benzodiazepines, among SARS-CoV-2 positive persons, but the incidence of psychiatric admissions did not increase, possibly simply because of relevant pharmacological treatment, which may have prevented some admissions.