Implication of evolutionary theory for psychiatry

It may well have been a coincidence that the announcement of the ‘breaking’ of the human genetic code and the publication of an editorial on psychiatry and Darwinism in the Journal occurred within the same week, but it is to be hoped that both of these events signal a new beginning. Abed (2000) asks whether the time has come for psychiatry to reconsider Darwinism: in fact, one could argue that if psychiatry as a science is to survive, there is no other option. Since its first publication in 1859, Darwin's evolutionary theory has transformed our understanding of the living world. The model has stood the test of time despite heavy resistance by religious groups, exploitation by Fascism and enthusiastic misinterpretation. The proliferation of papers on the subject in scientific journals over the past 30 years strongly suggests that it is here to stay. Evolutionary psychology has already established itself (Barkow et al, 1995). In contrast, only a few articles have been published by psychiatric journals, and evolutionary theory is largely ignored in psychiatric training worldwide.

If psychiatry has survived until now without using evolutionary theory, what would be the advantage of a theoretical shift? Psychiatry badly needs a theoretical framework (Kandel, 1998) that allows for the synthesis of knowledge accumulated by different schools that do not speak the same language and therefore do not interact with each other. Evolutionary theory is capable of integrating genetic, environmental, developmental and social explanations of behaviour and is therefore an excellent candidate (Leckman & Mayes, 1998). Furthermore, as Abed points out, the usefulness of the model can be tested by theory-driven research. Psychiatry has to take up the challenge. The application of modern evolutionary theory should lead to a more accurate understanding of human behaviour, including the origins and treatment of mental illness. Psychodarwinism became a term of abuse following atrocities perpetrated during the first half of the 20th century. It is time to learn the lessons of the past and move on. Attachment theory is one successful example of using evolutionary principles in psychiatry, and there will be more to come.