Longitudinal association between neighborhood-level social capital and incidence of major psychiatric disorders in a cohort of 1.4 million people in Sweden

Abstract Social capital—the trust and cohesion within communities—has been linked to mental health, yet longitudinal evidence remains scarce. Here we show that neighborhood-level personal trust predicts the incidence of severe mental illness in a large, population-based cohort in Stockholm County, Sweden. Among 1.47 million Swedish-born residents followed over 15 years, higher personal trust at baseline was associated with reduced rates of non-affective psychotic disorder and bipolar disorder without psychosis over the follow-up period, but only among individuals of Swedish or European heritage. In contrast, the same exposure increased incidence rates among those of North African, Middle Eastern or Sub-Saharan African heritage. Political and welfare trust showed no consistent associations. These findings suggest that social capital may confer mental health benefits or risks depending on one’s own social position, highlighting the need for nuanced public mental health strategies that consider structural and cultural contexts in promoting mental wellbeing.