Evolutionary psychiatry

Evolutionary psychiatry, also known as Darwinian psychiatry,^[1][2] is a theoretical approach to psychiatry that aims to explain psychiatric disorders in evolutionary terms.^[3][4] As a branch of the field of evolutionary medicine, it is distinct from the medical practice of psychiatry in its emphasis on providing scientific explanations rather than treatments for mental disorder. This often concerns questions of ultimate causation. For example, psychiatric genetics may discover genes associated with mental disorders, but evolutionary psychiatry asks why those genes persist in the population. Other core questions in evolutionary psychiatry are why heritable mental disorders are so common^[5] how to distinguish mental function and dysfunction,^[6] and whether certain forms of suffering conveyed an adaptive advantage.^[7] Disorders commonly considered are depression, anxiety, schizophrenia, autism, eating disorders, and others. Key explanatory concepts are of evolutionary mismatch (when modern environments cause mental health conditions) and the fact that evolution is guided by reproductive success rather than health or wellbeing. Rather than providing an alternative account of the cause of mental disorder, evolutionary psychiatry seeks to integrate findings from traditional schools of psychology and psychiatry such as social psychology, behaviourism, biological psychiatry and psychoanalysis into a holistic account related to evolutionary biology. In this sense, it aims to meet the criteria of a Kuhnian paradigm shift.

Though heavily influenced by evolutionary psychology,^[3] as Abed and St John-Smith noted in 2016, "Unlike evolutionary psychology, which is a vibrant and thriving sub-discipline of academic psychology with a strong and well-funded research program, evolutionary psychiatry remains the interest of a small number of psychiatrists who are thinly scattered across the world." It has gained increasing institutional recognition in recent years, including the formation of an evolutionary psychiatry special interest group within the Royal College of Psychiatrists and the Section on Evolutionary Psychiatry within the World Psychiatric Association,^[8] and has gained traction with the publication of texts aimed at the popular audience such as Good Reasons for Bad Feelings: Insight from the Frontier of Evolutionary Psychiatry^[7] by Randolph Nesse.