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ABSTRACT
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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