January 7, 2003

CONTENTS,  Special Issue, VOL.23 Dec 2002
VOL.22, 2001
VOL.21, 2000
VOL.20, 1999
VOL.19, 1998
VOL.18, 1997
bar_vert down.gif (6891 bytes)

including Psychoneuroimmunology, Neuro
Reproductive Medicine, Chronobiology
and Human Ethology
ISSN 0172–780X

Vol. 23, December 2002

Darwinian psychiatry and the concept of
mental disorder

Darwinian psychiatry and the concept of
mental disorder

Alfonso Troisi & Michael McGuire

Submitted: August 31, 2002
Accepted: September 8, 2002

Key words:
Darwinian psychiatry, mental disorder, functional impairment, suffering, statistical deviance, lesion

2002; 23(suppl 4) :3138
pii: NEL231002R03
PMID: 12496733

View pdf [150 kB]

Order pdf


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.    



1 Regier DA, Myers JK, Kramer M, Robins LN, Blazer DG, Hough RL et al. The NIMH Epidemiologic Catchment Area program: historical context, major objectives, and study population characteristics. Arch Gen Psychiatry 1984; 41:934–941.

2 Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 1994; 51:8–19.

3 Frances A. Problems in defining clinical significance in epidemiological studies. Arch Gen Psychiatry 1998; 55:119.

4 Spitzer RL. Diagnosis and need for treatment are not the same. Arch Gen Psychiatry 1998; 55:120.

5 McGuire MT, Troisi A. Darwinian psychiatry. New York: Oxford University Press; 1998.

6 McGuire MT, Troisi A. Evolutionary biology and psychiatry. In: BJ Sadock, VA Sadock, editors. Kaplan & Sadock’s comprehensive textbook of psychiatry, VII ed., vol. 1. Philadelphia: Lippincott Williams & Wilkins; 2000. pp. 484–492.

7 Boorse C. On the distinction between disease and illness. Philosophy and Public Affairs 1975; 5:49–68.

8 Hesslow G. Do we need a concept of disease? Theor Med 1993; 14:1–14.

9 Troisi A, McGuire MT. Evolution and mental health. In HS Friedman, editor. Encyclopedia of mental health, vol. 2. San Diego: Academic Press; 1998. pp. 173–181.

10 Taylor FK. The medical model of the disease concept. Br J Psychiatry 1976; 128:588–594.

11 Wulff HR, Andur Pedersen S, Rosenberg R. Philosophy of medicine: An introduction. Oxford: Blackwell; 1986.

12 American Psychiatric Association. Diagnostic and statistical manual of mental disorders, Fourth Edition (DSM-IV). Washington, DC: American Psychiatric Association, 1994.

13 McGuire MT, Troisi A, Raleigh MM. Depression in evolutionary context. In S Baron-Cohen, editor. The maladapted mind: Classic readings in evolutionary psychopathology. Hove, UK: Psychology Press; 1997. pp. 255–282.

14 Nesse RM. Is depression an adaptation? Arch Gen Psychiatry 2000; 57:14–20.

15 Troisi A, McGuire MT. Evolutionary biology and life events research. Arch Gen Psychiatry 1992; 49:501–502.

16 Troisi A. Gender differences in vulnerability to social stress: A Darwinian perspective. Physiol Behav 2001; 73:443–449.

17 Regier DA, Kaelber CT, Rae DS, Farmer ME, Knauper B, Kessler RC et al. Limitations of diagnostic criteria and assessment instruments for mental disorders: Implications for research and policy. Arch Gen Psychiatry 1998; 55:109–115.

18 Panksepp J. Affective neuroscience. The foundations of human and animal emotions. New York: Oxford University Press; 1998.

19 Nesse RM. Evolutionary explanations of emotions. Hum Nature 1990; 1:261–289.

20 Nesse RM, Berridge KC. Psychoactive drug use in evolutionary perspective. Science 1997; 278:63–66.

21 Olds J, Milner P. Positive reinforcement produced by electrical stimulation of the septal area and other regions of rat brain. J Comp Physiol Psychol 1954; 47:419–427.

22 Troisi A. Harmful effects of substance abuse: a Darwinian perspective. Funct Neurol 2001; 16:237–243.

23 Cohen H. The evolution of the concept of disease. In AL Caplan, HT Engelhardt, Jr., JJ McCartney, editors. Concepts of health and disease: Interdisciplinary perspectives. Reading, MA: Addison-Wesley; 1981. pp. 209–220.

24 Kendell RE. The role of diagnosis in psychiatry. Oxford: Blackwell; 1975.

25 Wakefield JC. The concept of mental disorder: On the boundary between biological facts and social values. Am Psychologist 1992; 47:373–388.

27 Setchell JM, Dixson AF. Arrested development of secondary sexual adornments in subordinate adult male mandrills (Mandrillus sphinx). Am J Phys Anthropol 2001; 115:245–252.

26 Futuyma DJ. Evolutionary Biology, 2nd edn. Sunderland, MA: Sinauer Associates, Inc.; 1986.

28 Maggioncalda AN, Czekala NM, Sapolsky RM. Growth hormone and thyroid stimulating hormone concentrations in captive male orangutans: implications for understanding developmental arrest. Am J Primatol 2000; 50:67–76.

29 Maggioncalda AN, Sapolsky RM, Czekala NM. Reproductive hormone profiles in captive male orangutans: implications for understanding developmental arrest. Am J Phys Anthropol 1999; 109:19–32.

30 Galdikas B. Adult male sociality and reproductive tactics among orangutans at Tanjung Puting. Folia Primatol 1985; 45:9–24.

31 Mealey L. The sociobiology of sociopathy: An integrated evolutionary model. Behav Brain Sci 1995; 18:523–599.

32 Troisi A, McGuire MT. Deception and somatizing disorders. In CN Stefanis, AD Rabavilas, CR Soldatos, editors. Psychiatry: A world perspective, vol. 3. Amsterdam: Excerpta Medica; 1991. pp. 973–978.

33 Sroufe LA. The role of infant-caregiver attachment in development. In J Belsky, T Nezworski, editors. Clinical implications of attachment. Hillsdale, NJ: Erlbaum; 1988. pp. 18–38.

34 Belsky J. Modern evolutionary theory and patterns of attachment. In J Cassidy, PR Shaver. Handbook of attachment: Theory, research, and clinical applications. New York: The Guilford Press; 1999. pp. 141–161.

35 Virchow R. Hundert Jahre Allgemeiner Pathologie. Berlin: August Hirschwald; 1895.

36 Schneider K. Klinische Psychopathologie (3rd edn). Stuttgart: Thieme; 1950.

37 Szasz TS. The myth of mentall illness. Foundations of a theory of personal conduct (rev. ed.). New York: Harper & Row; 1974.

38 Ludwig AM. The psychiatrist as physician. J Am Med Ass 1975; 234:603–604.

39 Guze SB. Why psychiatry is a branch of medicine. New York: Oxford University Press; 1992.

40 Andreasen NC. The validation of psychiatric diagnosis: New models and approaches. Am J Psychiatry 1995; 152:161–162.

41 Detre T, McDonald MC. Managed care and the future of psychiatry. Arch Gen Psychiatry 1997; 54:201–204,.

42 Schwartz JM, Stoessel PW, Baxter LR, Martin KM, Phelps ME. Systematic changes in cerebral glucose metabolic rate after successful behavior modification treatment of obssessive-compulsive disorder. Arch Gen Psychiatry 1996; 53:109–113.

43 Pardo JV, Pardo Pj, Raichle ME. Neural correlates of self-induced dysphoria. Am J Psychiatry 1993; 150:713–719.

44 Harrison PJ, Everall IP, Catalan J. Is homosexual behaviour hard-wired? Sexual orientation and brain structure. Psychol Med 1994; 24:811–816.

45 Marazziti D, Akiskal HS, Rossi A, Cassano GB. Alteration of the platelet serotonin transporter in romantic love. Psychol Med 1999; 29:741–745.

46 Raine A, Buchsbaum MS, Stanley J, Lottenberg S, Abel L, Stoddard J. Selective reductions in prefrontal glucose metabolism in murderers. Biol Psychiatry 1994; 36:365–373.

47 Scadding JG. Diagnosis: the clinician and the computer. Lancet 1967; 2:877–882.

48 Klein DF. A proposed definition of mental illness. In RL Spitzer, DF Klein, editors. Critical issues in psychiatric diagnosis. New York: Raven Press; 1978. pp. 41–71.

Darwinian psychiatry and the concept of mental disorder"

1. Secure online payment, PDF USD 35.00:  
Buy PDF Now
      Check Out
Goods and services provided by Neuroendocrinology Letters
Sold by 2CheckOut.com Inc. (Ohio, USA).

2. Send also an email to: publisher@nel.edu with following information:
Vol.23 Special Issue (suppl.4). ARTICLE TITLE:
"Darwinian psychiatry and the concept of mental disorder" -- pdf article order.
Delivery method: _____ (either email or fax or regular airmail). Thank you.

"Human Ethology and Evolutionary Psychology"

1. Payment can be made by check or wire transfer.
Please contact publisher@nel.edu for details.

2. Online CreditCard payment through Secure Server.
Please follow the links below:
Buy Now    Check Out
Goods and services provided by Neuroendocrinology Letters
Sold by 2CheckOut.com Inc. (Ohio, USA).

including Psychoneuroimmunology, Neuro
Reproductive Medicine, Chronobiology
and Human Ethology
ISSN 0172–780X

A peer-reviewed transdisciplinary Journal covering Neuroendocrinology, Psychoneuroimmunology, Neuropsychopharmacology, Reproductive Medicine, Chronobiology and Human Ethology for RAPID publication of Original Papers, Review Articles, State-of-the-Art, Clinical Reports, Meta-Analyses and other contributions from all the fields covered by Neuroendocrinology Letters. E-mail: info@nel.edu

Copyright  Neuroendocrinology Letters 2001
All rights reserved. No part may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or ortherwise, without prior written permission from the Editor-in-Chief: editor@nel.edu
  Web of Science, Science Citation Index, (on the Internet), ISI, PA, USA
  Research Alert (a current awareness service), ISI, PA, USA
  Neurosciences Citation Index (on compact disk), ISI, PA, USA
  MEDLINE / Index Medicus

  Excerpta Medica
  Chemical Abstracts

View current statistics