Pediaditakis Nicholas
Department of Psychiatric Medicine, ECU Brody School of Medicine,Greenville, NC, USA.
Open Neurol J. 2016 Dec 30;10:149-154. doi: 10.2174/1874205X01610010149. eCollection 2016.
Conciliating recent findings from molecular genetics, evolutionary biology, and clinical observations together point to new understandings regarding the mechanism, development and the persistent worldwide prevalence of major mental disorders (MMDs), which should be considered the result of an evolutionary downside trade off. Temperamental/trait variability, by facilitating choices for individual and group responses, confers robustness flexibility and resilience crucial to success of our species. Extreme temperamental variants, originating evolutionarily from the asocial aspect of human nature, also constitute the premorbid personality of the disorders. The latter create vulnerable individuals out of whom some will develop MMDs but at much higher rate to that of the general population. Significantly, similar temperamental "lopsidedness" enables many of these vulnerable individuals, if intelligent, tenacious, and curious, to be creative and contribute to our survival while some may also develop MMDs. All have a common neural-developmental origin and share characteristics in their clinical expression and pharmacological responses also expressed as mixed syndromes or alternating ones over time. Over-pruning of synaptic neurons may be considered the trigger of such occurrences or conversely, the failure to prevent them in spite of it. The symptoms of the major mental disorders are made up of antithetical substitutes as an expression of a disturbed over-all synchronizing property of brain function for all higher faculties previously unconsidered in their modeling. The concomitant presence of psychosis is a generic common occurrence.
综合分子遗传学、进化生物学和临床观察的最新发现，共同指向了对主要精神障碍（MMDs）的机制、发展及其在全球持续流行的新理解，这些应被视为进化劣势权衡的结果。气质/特质变异性通过促进个体和群体反应的选择，赋予了对我们物种成功至关重要的稳健性、灵活性和恢复力。极端的气质变体在进化上源于人性的反社会方面，也构成了这些障碍的病前人格。后者造就了易患病个体，其中一些人会患上MMDs，但发病率远高于普通人群。值得注意的是，类似的气质“失衡”使许多这样的易患病个体，如果聪明、坚韧和好奇，能够具有创造力并为我们的生存做出贡献，而有些人可能也会患上MMDs。所有这些都有共同的神经发育起源，在临床表达和药理反应方面也有共同特征，随着时间的推移也表现为混合综合征或交替综合征。突触神经元的过度修剪可能被认为是此类情况的触发因素，或者相反，尽管如此却未能预防它们。主要精神障碍的症状由对立的替代物组成，这是大脑功能对所有先前在其模型中未被考虑的高级功能的整体同步特性受到干扰的一种表现。精神病的伴随出现是一种普遍常见的情况。
