Immunologic Research

, Volume 66, Issue 6, pp 663–667 | Cite as

The link between schizophrenia and hypothyroidism: a population-based study

  • Kassem Sharif
  • Shmuel Tiosano
  • Abdulla Watad
  • Doron Comaneshter
  • Arnon D. Cohen
  • Yehuda Shoenfeld
  • Howard AmitalEmail author
Original Article


Schizophrenia is considered to be of the severe psychiatric disorders characterized by chronic debilitating course marked with frequent relapses and high clinical and financial burden. Aberrations of thyroid hormone levels have been documented in several psychiatric conditions including bipolar disease. The aim of this study is to provide insight into whether an association exists between hypothyroidism and schizophrenia. A population-based cross-sectional study was conducted using data retrieved from the largest medical records database in Israel, the Clalit Health Services (CHS). Patients were defined as having hypothyroidism or schizophrenia when there was at least one such documented diagnosis in their medical records. The proportion of schizophrenia was compared between hypothyroid and age- and sex frequency-matched healthy controls. A logistic regression model was used to estimate the association between psychiatric manifestations and hypothyroidism in a multivariate analysis adjusted for age, gender, and smoking status. The study included 40,843 patients with hypothyroidism and 40,918 age- and sex frequency-matched controls. The proportion of schizophrenia in hypothyroid patients was higher than that in controls (2.01% vs. 1.25%, respectively, p < 0.0001). Multivariate logistic regression demonstrated a robust independent association between hypothyroidism and schizophrenia (OR 1.62, p ≤ 0.001). Our study confirms a higher proportion of hypothyroidism among patients with schizophrenia. The awareness of such interrelation should drive physicians treating patients with schizophrenia to consider screening for hypothyroidism. Further studies are required to elucidate the underlying mechanism or the common denominator favoring the co-occurrence of schizophrenia and hypothyroidism.


Hypothyroidism Schizophrenia Autoimmunity Thyroid dysfunction Psychosis 


Compliance with ethical standards

The study was approved by the Ethical Committee of CHS, located at the Soroka Medical Center, Beer Sheva, Israel.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kassem Sharif
    • 1
    • 2
    • 3
  • Shmuel Tiosano
    • 1
    • 3
  • Abdulla Watad
    • 1
    • 2
    • 3
  • Doron Comaneshter
    • 4
  • Arnon D. Cohen
    • 4
    • 5
  • Yehuda Shoenfeld
    • 2
    • 3
    • 6
  • Howard Amital
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of Medicine ‘B’Sheba Medical CenterTel HashomerIsrael
  2. 2.Zabludowicz Center for Autoimmune DiseasesSheba Medical CenterTel HashomerIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Chief Physician’s Office, Faculty of Health SciencesClalit Health Services Tel AvivTel AvivIsrael
  5. 5.Siaal Research Center for Family Medicine and Primary Care, Faculty of Health SciencesBen Gurion University of the NegevBeer ShevaIsrael
  6. 6.Incumbent of Laura Schwarz-Kioo Chair for Research of Autoimmune DiseasesTel Aviv UniversityTel AvivIsrael

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