Amresh Shrivastava Environmental factors are acknowledged as key determinants of development of schizophrenia. Studies suggest that the altered expression of genes and proteins involved in numerous neurodevelopmental, metabolic and neurotransmitter pathways can result from inadequate amounts of modulators, transporters and, synthesizers. Advances in the prenatal period in the genesis of schizophrenia suggest that environmental factors and HPA axis may establish a vulnerability to the disease. Further, the onset of psychotic disorders may be associated with a higher rate of stress and change to the hippocampus. Thyroid hormone is a possible link between genes and environment. Its dysfunction has been observed during antipsychotic treatment, malignant neuroleptic syndrome treatment resistance, and chronic schizophrenia. It is regulated by the Hypothalamic Pituitary Adrenal gland (HPA) axis, which is an associated endocrinal abnormality in psychosis. Molecular and genetic studies suggest that the thyroid hormone receptor is necessary in mediating developmental effects of thyroid hormone. It is a plausible neuromodulator that can bridge genes and environment. Thyroid hormones also regulate the expression of many neurotransmitters, their synthesizing enzymes, and receptors. This study examined the status of the thyroid hormone in an early psychosis cohort in which we studied thyroid hormone levels in a cohort of early psychosis patients using a cross-sectional design. In a cohort of 60 patients, 43 (71.6%) were hypothyroid (mean TSH = 5.2 mU/L). However, TSH levels did not significantly correlate with the PANSS total scores or the duration of illness. The level of TSH did however show a positive correlation with the negative symptoms scale of the PANSS (p<0.03). A significant positive correlation with negative symptoms indicates that a hypothyroid state may be a symptom that concomitantly explains the co-existence of depressive and negative symptoms in some patients. This likely has implications for psychiatric management in both the short and long term.