No study in the review proves that owning a cat causes schizophrenia or that an individual cat owner’s absolute risk doubles. A systematic review and meta-analysis found an association between broadly defined cat exposure and schizophrenia-related outcomes in observational studies. Its estimates varied with the studies included, and the authors cautioned that the evidence has quality limitations.
What does “twice the odds” mean?
The headline refers to pooled odds ratios, a way of comparing the odds of an outcome between groups in studies. An odds ratio is not an estimate of an individual’s absolute probability. So the review’s figures do not mean that a particular cat owner is twice as likely to develop schizophrenia, or that owning a cat doubles anyone’s personal chance of diagnosis.
The figures come from a systematic review by John J. McGrath, Carmen C. W. Lim and Sukanta Saha, published in Schizophrenia Bulletin. The authors searched for studies published from January 1, 1980, through May 30, 2023. They included 17 articles from 11 countries, covering different kinds of cat exposure and schizophrenia-related outcomes. Read the review.
What estimates did the review find?
The pooled estimates were based on observational studies. They changed when the researchers excluded certain studies, which is one reason to treat them as evidence of an association rather than a settled measure of risk.
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| Analysis | Pooled odds ratio | What it represents |
|---|---|---|
| Unadjusted, all included estimates | 2.14 (95% confidence interval 1.29–3.55; 10 estimates) | Unadjusted association across the estimates included in this analysis. |
| Unadjusted, after removing one outlier | 1.56 (95% confidence interval 1.27–1.92; nine estimates) | Sensitivity analysis showing how the pooled estimate changed when one outlier was excluded. |
| Adjusted, all included estimates | 2.44 (95% confidence interval 1.59–3.73; five estimates) | Adjusted association across the estimates included in this analysis. |
| Adjusted, after excluding one study with suboptimal exposure or design features | 2.40 (95% confidence interval 1.50–3.86; four estimates) | Sensitivity analysis excluding one study on the grounds described by the review authors. |
These are pooled odds ratios reported by the review, not absolute-risk estimates. The confidence intervals express statistical uncertainty, and the substantial change in the unadjusted result after removing an outlier shows that the pooled figure depends in part on which studies are included. The authors also noted that several studies in the pooled analyses had low quality scores.
What counted as cat exposure—and as an outcome?
The review did not examine only a single, consistent measure of pet ownership. Its exposure definitions included cat ownership, cat bites and cat contact. Outcomes included broadly defined schizophrenia-related disorders, as well as psychotic-like experiences. Those differences matter: a finding about a broad category of exposure and outcomes is not automatically a finding about household cat ownership causing a clinical diagnosis of schizophrenia.
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The authors could not pool results for psychotic-like experiences because the studies measured them too differently. Findings were mixed. They also reported that higher-quality studies indicated that associations in unadjusted models may reflect confounding—other factors associated with both exposure and outcome.
Does this show that cats cause schizophrenia?
No. The included studies were observational, and an association in observational research cannot by itself establish that one factor caused another. The review identifies a signal worth studying, but its authors call for more high-quality research and advise caution in interpreting the pooled results.
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The review’s search covered studies published through May 30, 2023. It was published online in December 2023 and appeared in a 2024 journal issue. Those dates do not establish whether research published after the search cutoff changes the evidence; the review itself cannot answer that question.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What about Toxoplasma gondii?
The parasite Toxoplasma gondii is a proposed pathway in discussions of cat exposure and schizophrenia-related outcomes. But the review does not establish that the parasite explains the association, and cat ownership is not the same thing as infection.
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People can acquire Toxoplasma through routes other than cats, including eating undercooked meat containing tissue cysts or consuming contaminated food or water. NIH pediatric opportunistic-infection guidance says cats shed oocysts only transiently after initial infection and notes that most studies have failed to show a correlation between cat ownership and Toxoplasma infection in humans. See the NIH guidance.
What should cat owners do with this information?
This review is not a reason to conclude that a pet cat causes schizophrenia, or to use cat ownership alone as a measure of Toxoplasma infection. It also does not establish a test, product or other purchase that prevents schizophrenia. The evidence supports a cautious reading of an observed association—not a proven causal chain from cats to infection to a psychiatric diagnosis.
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