There is accumulating evidence that individuals with schizophrenia show altered levels of thyroid hormones. However, a qualitative and quantitative synthesis of findings in this field has not been performed so far. Therefore, we aimed to perform a systematic review and meta-analysis of studies investigating the levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), total thyroxine (tT4), free triiodothyronine (fT3) and total triiodothyronine (tT3) in multiple-episode schizophrenia (MES) and first-episode psychosis (FEP). Electronic databases were searched from their inception until 30th May 2020 by two independent reviewers. Random-effects meta-analyses and meta-regression analyses were performed. Altogether, 19 studies were included. Persons with FEP had significantly lower TSH levels (5 studies, g = −0.26, 95%CI: −0.47 to −0.06, p = 0.013, I² = 21.3%), higher fT4 levels (3 studies, g = 0.58, 95%CI: 0.15–1.01, p = 0.008, I² = 64.6%) and lower tT3 levels (2 studies, g = −0.60, 95%CI: −0.82 to −0.37, p < 0.001, I² = 0%) compared to controls. Elevated TSH levels were found in persons with MES (13 studies, g = 0.20, 95%CI: 0.02–0.39, p = 0.031, I² = 50.0%). Our findings imply that the levels of TSH might be decreased in persons with FEP and increased in those with MES. Other alterations need to be confirmed by additional studies. These findings imply the need to monitor the levels of TSH and thyroid hormones from the onset of psychosis.

越来越多的证据表明，精神分裂症患者的甲状腺激素水平发生了变化。然而，迄今为止尚未对该领域的发现进行定性和定量的综合。因此，我们旨在对研究促甲状腺激素 (TSH)、游离甲状腺素 (fT4)、总甲状腺素 (tT4)、游离三碘甲状腺原氨酸 (fT3) 和总三碘甲状腺原氨酸 (tT3) 水平的研究进行系统回顾和荟萃分析多发精神分裂症（MES）和首发精神病（FEP）。两名独立审稿人检索了电子数据库从开始到 2020 年 5 月 30 日的时间。进行了随机效应荟萃分析和荟萃回归分析。共纳入 19 项研究。FEP 患者的 TSH 水平显着降低（5 项研究，g = -0.26，95%CI：-0.47 至 -0.06，p  = 0.013，I ²  = 21.3%），更高的 fT4 水平（3 项研究，g = 0.58，95%CI：0.15–1.01，p  = 0.008，I ²  = 64.6%）和更低的 tT3 水平（2 项研究，g = -0.60, 95%CI: -0.82 to -0.37, p  < 0.001, I ²  = 0%) 与对照组相比。在 MES 患者中发现 TSH 水平升高（13 项研究，g = 0.20，95%CI：0.02–0.39，p  = 0.031，I ²  = 50.0%）。我们的研究结果表明 FEP 患者的 TSH 水平可能会降低，而 MES 患者的 TSH 水平可能会升高。其他改变需要通过额外的研究来证实。这些发现意味着需要从精神病发作开始监测 TSH 和甲状腺激素的水平。