Although the College of Psychiatrists of Ireland is a relatively new college with small numbers in comparison to the Royal College of Psychiatrists (UK), there are 10 faculties and 7 special interest groups (SIGs) to date. The College of Psychiatrists of Ireland has currently 1283 members in total, of whom 720 are consultants, 290 are at basic specialist trainee level and 162 are at higher specialist trainee level. It is estimated that there are approximately a further 280 doctors working as psychiatrists at different levels in Ireland who are not registered with the college.
The average size of SIGs is 141, with the evolution and psychiatry SIG (at 52) being the second smallest to date, but one of the newest. Other SIGs include Autism, ADHD, physical illness in mental illness, eating disorders, global mental health and personality disorders. The evolution and psychiatry SIG also have an active WhatsApp group of 57 participants, including other clinicians with an interest in evolutionary medicine.
Interest and research in evolutionary psychiatry has been rapidly growing over the last two decades with several notable publications by world renowned authors such as Randolph Nesse, John Price, Martin Brune, Alfonso Triosi and Riadh Abed (Abed, Reference Abed2000; Brüne, Reference Brüne2016; Stevens & Price, Reference Stevens and Price2000).
Although evolution and an appreciation of its central importance as an ultimate overarching framework for biology is widely held, it is conspicuously absent from modern medical curricula, education and postgraduate training. This fact has been highlighted by Henry O’Connell (the founding chair of the Evolution and Psychiatry SIG) in a number of published articles over the years (O’Connell, Reference O’Connell2004, Reference O’Connell2007, Reference O’Connell2008, Reference O’Connell2009).
The Royal College of Psychiatrists Evolutionary Psychiatry Special Interest Group (EP SIG) was established in 2016 and evolutionary psychiatry began to gain traction as a legitimate discipline. Then for Darwin Day (February 12th) 2019, Henry O’Connell presented on evolution and psychiatry at a postgraduate education meeting and discovered colleagues with shared interests. Over the subsequent year, alongside trainees Mara Petrut and Diarmuid Boyle, O’Connell gave general presentations at College of Psychiatrists of Ireland and University of Limerick academic meetings on the application of evolutionary thinking to psychiatry. Receiving positive feedback ultimately prompted an application to set up the Evolution and Psychiatry Special Interest Group in late 2020. Undeniably, the COVID-19 pandemic played a catalytic role, encouraging personal reflection and allowing for international collaboration and meetings online.
The SIG is now over 2 years in existence and is going strong. Our main contributions to date have been our academic meetings, which are held in February (to mark Darwin Day), May and October. Our lectures to date were as follows:
(i) Mike Watts, who presented a wide ranging overview of evolution from the evolution of ATP right through to applications in clinical medicine. (ii) Riadh Abed, who presented on evolution and eating disorders. (iii) Annie Swanepoel, who presented on evolutionary aspects of autism and ADHD. (iv) In February 2022, Randolph Nesse, a founder of the field of evolutionary psychiatry, gave a general overview under the title of ‘Why has natural selection not eliminated mental disorders’. (v) In May 2022, Adam Hunt presented on evolutionary aspects of psychopathology and autism. (vi) In October 2022, Kevin Mitchell presented on the ‘whys’ of psychiatric illness, from a genetic and evolutionary perspective. Further meetings featuring similar notable speakers are planned for the SIG.
There have been several publications on evolution and psychiatry by members of the SIG. In 2021, along with Petrut, Boyle and with input from Abed and Nesse, an overview article on evolution and psychiatry in the College of Psychiatrists of Ireland Trainee newsletter ThinkTank was published with a further contribution to the Royal College EP SIG newsletter in 2021. Also published was a review of Nesse’s ‘Good Reasons for Bad Feelings’ in the Irish Journal of Psychological Medicine in 2021 (O’Connell et al. Reference O’Connell, Petrut and Boyle2021). Gurjot Brar, senior registrar, who has recently taken position as Vice-Chair has also started to write on the topic with Henry O’Connell, including a letter on evolutionary aspects of psychedelic drug use in psychiatry, published by the Irish Journal of Psychological Medicine (Brar & O’Connell, Reference Brar and O'Connell2023). A review of Abed and St John-Smith’s edited volume on Evolutionary Psychiatry has been accepted for publication by the British Journal of Psychiatry. Additionally a review of Dunbar’s most recent book, on evolution and religion has been accepted for publication by the British Journal of Psychology.
There have been several other initiatives in the field of evolution and psychiatry in Ireland recently. Over the last 18 months a recurring lecture on evolution and psychiatry for final year medical students at the University of Limerick has been introduced. Eimear Ni Mhuircheartaigh, senior registrar, is doing a Masters course in medical education and will be looking specifically at how evolution can be introduced into medical curricula and examinations. At a postgraduate level, Henry O’Connell has made some initial proposals to our college Chief Examiner regarding inclusion of evolution in curriculum and examinations for the College of Psychiatrists of Ireland. Finally, an essay prize for college trainees has been established, with inaugural joint winners Silva Vartukapteine and Gurjot Brar announced at the recent Spring Conference 2023.
Henry O’Connell has also recently written ‘Evolution and Psychiatry: Clinical Cases’ (O’Connell, Reference O’Connell2022). This book attempts to outline how evolutionary perspectives can help inform assessment and treatment of various psychiatric disorders using medical education principles such as learning objectives, and horizontal and vertical integration of knowledge.
In collaboration with the Royal College of Psychiatrist’s EP SIG, we have also started to contribute to the Evolutionary Psychiatry Section of the World Psychiatric Association.
The future
Since the introduction of the concept of evolutionary psychiatry in the late 1990s, the field has expanded profoundly with an ever expanding literature base. In recent years, we have had the publication of two books that should prove to be seminal texts for this field for the next decade (Nesse, Reference Nesse2020; Abed & St John-Smith, Reference Abed and St John-Smith2022). So, for current and future trainees, there is much more to read and become familiar with and there are now organisations at national and international levels that are disseminating knowledge on evolution.
Evolutionary psychiatry is contributing in a meaningful way through medical education and clinical applications. Regarding medical education, based on our experience to date in our own careers, the lectures for medical students and reviewing of the literature, we realise the central importance of introducing evolution to doctors of the future at postgraduate level, at medical school and possibly even earlier. We are hoping to further develop our lecture programme at the University of Limerick and to push for inclusion of evolutionary principles in the curriculum and examinations. Likewise, we hope to introduce evolutionary principles into the curriculum and examinations for postgraduate psychiatric training in Ireland.
Regarding clinical applications and making evolutionary concepts relevant to busy clinicians, areas for development include Nesse’s ‘smoke detector’ principle in managing anxiety and panic (Nesse, Reference Nesse2019) and compassion focussed therapy as developed by Paul Gilbert (Reference Gilbert2010). It is quite possible, the biopsychosocial model developed by Engel (Reference Engel1977) could be enhanced with an evolutionary perspective, providing ‘ultimate’ explanations for our patients’ symptoms (Hunt et al. Reference Hunt, St John-Smith, Abed, Abed and St John-Smith2022). However, even in the absence of overt clinical applications we know that having the evolutionary perspective in mind as an essential basic science makes us more curious and satisfied scientists and most importantly, more effective clinicians.
Finally, collaboration is essential. Many psychiatrists all over the world are interested in evolution and psychiatry and by reaching out to each other we can share ideas and learn from each other. As the numbers of people thinking about evolution and psychiatry increase, we will undoubtedly also increase research outputs and clinical applications. Thus we would welcome and encourage interested readers to join the Evolutionary Psychiatry Special Interest Group, to attend our meetings, and to attend the various lectures provided by the World Psychiatric Association Evolutionary Psychiatry Section.
Financial support
The authors state that no funding was acquired.
Competing interests
The authors have no conflicts of interest to disclose.
Ethical standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committee on human experimentation with the Helsinki Declaration of 1975, as revised in 2008.
