Study 2 — Time-to-Guideline: Toxoplasma gondii and Psychiatry

Study 2 of the Hidden Infections research series. Toxoplasma gondii seroprevalence is elevated in patients with first-episode psychosis (FEP), schizophrenia, and bipolar disorder across multiple meta-analyses spanning 60 years of published evidence. Despite this, zero of six major international psychiatric guidelines (APA, NICE, RANZCP, BAP, WFSBP, Indian Psychiatric Society) include Toxoplasma serology in FEP workup. This study quantifies the evidence-to-guideline lag for this association at 70-73 years — the longest documented lag in the series — and identifies the structural reasons for the gap: psychiatric and parasitological evidence existing in non-overlapping literature streams without cross-speciality synthesis. A companion decision analysis (Study 13) demonstrates cost-effectiveness of routine FEP serology at treatment response rates >=10%. Group A: Institutional lag and diagnostic failure. CC0 public domain. AI-assisted draft pre-print.