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Evolution and psychiatry

Published online by Cambridge University Press:  02 January 2018

Athanassios Douzenis
Affiliation:
Athens University Medical School, 2nd Psychiatry Department, Attikon University Hospital, 7 Rimini Street, Athens 12462, Greece. Email: thandouz@med.uoa.gr
Dionisios Seretis
Affiliation:
Athens University Medical School, 2nd Psychiatry Department, Attikon University Hospital, 7 Rimini Street, Athens 12462, Greece. Email: thandouz@med.uoa.gr
Emmanouil Rizos
Affiliation:
Athens University Medical School, 2nd Psychiatry Department, Attikon University Hospital, 7 Rimini Street, Athens 12462, Greece. Email: thandouz@med.uoa.gr
Ioannis Michopoulos
Affiliation:
Athens University Medical School, 2nd Psychiatry Department, Attikon University Hospital, 7 Rimini Street, Athens 12462, Greece. Email: thandouz@med.uoa.gr
Christos Christodoulou
Affiliation:
Athens University Medical School, 2nd Psychiatry Department, Attikon University Hospital, 7 Rimini Street, Athens 12462, Greece. Email: thandouz@med.uoa.gr
Leftaris Lykouras
Affiliation:
Athens University Medical School, 2nd Psychiatry Department, Attikon University Hospital, 7 Rimini Street, Athens 12462, Greece. Email: thandouz@med.uoa.gr
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2010 

If evolution is the missing half of a ‘truly biological psychiatry’, Reference Nesse1 the other half being biological reductionism, then value is out of the picture. But this cannot be. We do not deny the gains from biology or those that are to come (millions of people manage to live because of advances in this field). Nor are we pessimistic about the potential gains that evolution claims for mental healthcare. However, these two ‘halves’ do not make a whole. We understand the aspiration for a truly biological psychiatry: life would be easier. Biology (although a big part, or the major part of the picture) cannot (alas!) be the whole, and evolutionary theoretical considerations of disorder, natural function, design and the like cannot fill what is missing. The reason is that even if we accept a value-free account of naturally selected mechanisms, physical as well as mental, these must be considered within the spectrum of individual and social values. Fulford Reference Fulford, Thornton and Graham2 explains why values are so feared. Other theorists who have considered evolution in terms of disorder also accept the indisputable place of values in psychiatry. Psychiatry is conceptually and empirically more complex than the rest of medicine. Every now and then a claim is made for a concept that will push psychiatry to an exclusively biological future. But psychiatry must be the avant-garde of science, rather than the runner-up of medicine, for perspectives which truly add to those complexities (empirical as well as philosophical) to do justice to themselves. Reference Fulford3

Psychiatry's interest in evolutionary theory is not new. The authors will be familiar with the views of Scadding, Kendell and Boorse, who all attempted to define disease in evolutionary terms. Accounts of disorder based on evolutionary theory allegedly offered the epistemological background for a value-free conceptualisation of disease. This is one way out of psychiatry's embarrassment when comparing itself against the scientific status of the rest of medicine and the medical model. However, this seems to be a misuse of natural selection, dressed in the colours of realism in order to enhance a ‘scientific’ psychiatry.

We do not argue that evolutionary theory has no role to play. Evolutionary psychology may offer new significant ways of approaching mental disease. But let us hope that this interest in Darwin will not be a pretext for blind reductionism and a return to a fact/value dichotomy. Britain is in the front line of value-based and evolution-based considerations with the work of Fulford, Thornton, Reference Thornton4 Bolton Reference Bolton5 and others. Great heritage, greater present.

Footnotes

Edited by Kiriakos Xenitidis and Colin Campbell

References

1 Nesse, RM. Evolution at 150: time for truly biological psychiatry. Br J Psychiatry 2009, 195: 471–2.Google Scholar
2 Fulford, KWM, Thornton, T, Graham, G. Oxford Textbook of Philosophy and Psychiatry. Oxford University Press, 2006.Google Scholar
3 Fulford, KWM. Teleology without tears: naturalism, neo-naturalism, and evaluationism in the analysis of function statements in biology (and a bet on the twenty-first century). Philos, Psychiatry Psychol 2000; 7: 7794.Google Scholar
4 Thornton, T. Essential Philosophy of Psychiatry. Oxford University Press, 2007.Google Scholar
5 Bolton, D. Alternatives to disorder. Philos Psychiatry Psychol 2000; 7: 141–53.Google Scholar
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