Durisko Zachary, Mulsant Benoit H, McKenzie Kwame, Andrews Paul W
Centre for Addiction and Mental Health (CAMH), Toronto, Ontario Evolutionary Ecology of Health Research Laboratories, Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario
Centre for Addiction and Mental Health (CAMH), Toronto, Ontario Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario.
Can J Psychiatry. 2016 Mar;61(3):159-65. doi: 10.1177/0706743716632517. Epub 2016 Feb 12.
Evolutionary approaches to medicine can shed light on the origins and etiology of disease. Such an approach may be especially useful in psychiatry, which frequently addresses conditions with heterogeneous presentation and unknown causes. We review several previous applications of evolutionary theory that highlight the ways in which psychiatric conditions may persist despite and because of natural selection. One lesson from the evolutionary approach is that some conditions currently classified as disorders (because they cause distress and impairment) may actually be caused by functioning adaptations operating "normally" (as designed by natural selection). Such conditions suggest an alternative illness model that may generate alternative intervention strategies. Thus, the evolutionary approach suggests that psychiatry should sometimes think differently about distress and impairment. The complexity of the human brain, including normal functioning and potential for dysfunctions, has developed over evolutionary time and has been shaped by natural selection. Understanding the evolutionary origins of psychiatric conditions is therefore a crucial component to a complete understanding of etiology.
医学的进化方法能够揭示疾病的起源和病因。这种方法在精神病学领域可能特别有用,因为精神病学常常处理表现各异且病因不明的病症。我们回顾了进化理论先前的一些应用,这些应用突出了尽管存在自然选择且因自然选择而导致精神病症依然持续存在的方式。进化方法带来的一个启示是,一些目前被归类为疾病的状况(因为它们会造成痛苦和功能损害)实际上可能是由“正常”运作的(如自然选择所设计的)功能性适应所导致的。这类状况提示了一种可能产生替代干预策略的替代疾病模型。因此,进化方法表明,精神病学有时应从不同角度思考痛苦和功能损害。人类大脑的复杂性,包括正常功能和功能障碍的可能性,是在进化过程中发展而来的,并受到自然选择的塑造。因此,了解精神病症的进化起源是全面理解病因的关键组成部分。