Darwinian psychiatry and the concept of mental disorder

Bernhard Fink bernhard.fink at aon.at
Mon Jan 13 14:24:16 EST 2003

Darwinian psychiatry and the concept of mental disorder


Neuroendocrinology Letters,2002; 23(suppl 4):31-38

In this paper, we discuss the concept of mental disorder from the
perspective of Darwinian psychiatry. Using this perspective does not
resolve all of the quandaries which philosophers of medicine face
when trying to provide a general definition of disease. However, it
does take an important step toward clarifying why current methods of
psychiatric diagnosis are criticizable and how clinicians can
improve the identification of true mental disorders. According to
Darwinian psychiatry, the validity of the conventional criteria of
psychiatric morbidity is dependent on their association with
functional impairment. Suffering, statistical deviance, and physical
lesion are frequent correlates of mental disorders but, in absence
of dysfunctional consequences, none of these criteria is sufficient
for considering a psychological or behavioral condition as a
psychiatric disorder. The Darwinian concept of mental disorder
builds from two basic ideas: (1) the capacity to achieve biological
goals is the best single attribute that characterizes mental health;
and (2), the assessment of functional capacities cannot be properly
made without consideration of the environment in which the
individual lives. These two ideas reflect a concept of mental
disorder that is both functional and ecological. A correct
application of evolutionary knowledge should not necessarily lead to
the conclusion that therapeutic intervention should be limited to
conditions that jeopardize biological adaptation. Because one of the
basic aims of medicine is to alleviate human suffering, an
understanding of the evolutionary foundations of the concept of
mental disorder should translate into more effective ways for
promoting individual and social well-being, not into the search for
natural laws determining what is therapeutically right or wrong.


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