Biology & Philosophy

, Volume 22, Issue 4, pp 513–528 | Cite as

Evolutionary psychiatry and the schizophrenia paradox: a critique



Evolutionary psychiatrists invariably consider schizophrenia to be a paradox: how come natural selection has not yet eliminated the infamous ‘genes for schizophrenia’ if the disorder simply crushes the reproductive success of its carriers, if it has been around for thousands of years already, and if it has a uniform prevalence throughout the world? Usually, the answer is that the schizophrenic genotype is subject to some kind of balancing selection: the benefits it confers would then outbalance the obvious damage it does. In this paper, however, I will show that the assumptions underlying such evolutionary accounts of schizophrenia are at least implausible, and sometimes even erroneous. First of all, I will examine some factual assumptions, in particular about schizophrenia’s impact on reproductive success, its genetics, its history, and its epidemiology. Secondly, I will take a critical look at a major philosophical assumption in evolutionary psychiatric explanations of schizophrenia. Indeed, evolutionary psychiatrists take it for granted that schizophrenia is a natural kind, i.e. a bounded and objectively real entity with discrete biological causes. My refutation of this natural kind view suggests that schizophrenia is in fact a reified umbrella concept, covering a heterogeneous group of disorders. Therefore, schizophrenia, as we now know it, simply doesn’t have an evolutionary history.


Balancing selection Evolutionary psychiatry Heterogeneity Natural kinds Schizophrenia 


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I would like to thank all members of the Interdisciplinary Center for Evolution and Behaviour (ICEG), Jan Dirk Blom, Vishwajit Nimgaonkar, William Byne, and an anonymous referee for their thoughtful comments.


  1. Adriaens P. and De Block A. 2006. The evolution of a social construction: the case of male homosexuality. Perspect. Biol. Med. 49(4) (in press)Google Scholar
  2. Allen J., Sarich V. (1988). Schizophrenia in an evolutionary perspective. Perspectives in biology and medicine 32:132–53Google Scholar
  3. Avila M., Thaker G., Adami H. (2001). Genetic epidemiology and schizophrenia: a study of reproductive fitness. Schizophrenia Research 47: 233–241CrossRefGoogle Scholar
  4. Bentall R. et al. (1988). Abandoning the concept of ‘schizophrenia’: some implications of validity arguments for psychological research into psychotic phenomena. Br. J. Clin. Psychol. 27:303–324Google Scholar
  5. Bentall R. (1993). Deconstructing the concept of ‘schizophrenia’. J. Ment. Health 2:223–228Google Scholar
  6. Bhatia T. et al. (2003). Gender and procreation among patients with schizophrenia. Schizophrenia Research 68:387–394CrossRefGoogle Scholar
  7. Blom J. (2003). Deconstructing schizophrenia. An analysis of the epistemic and nonepistemic values that govern the biomedical schizophrenia concept. Boom, AmsterdamGoogle Scholar
  8. Böök J. (1953). Schizophrenia as a gene mutation. Acta Genet. 4:133–139Google Scholar
  9. Boyle M. 1990. Schizophrenia: A Scientific Delusion? Routledge, New YorkGoogle Scholar
  10. Brown J. (2003). Identification of candidate genes for schizophrenia based on natural resistance to infectious diseases. Acta Neuropsychiatrica 15(3):108–114CrossRefGoogle Scholar
  11. Brüne M. (2004). Schizophrenia – an evolutionary enigma?. Neuroscience and Biobehavioral Reviews 28:41–53CrossRefGoogle Scholar
  12. Burns J. (2003). An evolutionary theory of schizophrenia: cortical connectivity, metarepresentation, and the social brain. Behav. Brain Sci. 27(6):831–885CrossRefGoogle Scholar
  13. Byne W. et al. (1999). The neurochemistry of schizophrenia. In: Charney D., Nestler E., Bunney B. (eds). Neurobiology of Mental Illness. Oxford University Press, OxfordGoogle Scholar
  14. Carter M., Watts C. (1971). Possible biological advantages among schizophrenics’ relatives. Br. J. Psychiatry 118:453–460Google Scholar
  15. Charlton B. (2000). Psychiatry and the human condition. Radcliffe Medical Press, OxfordGoogle Scholar
  16. Cooper J. et al. (1972). Psychiatric Diagnosis in New York and London. Oxford University Press, OxfordGoogle Scholar
  17. Crow T. (2000). Schizophrenia as the price that Homo sapiens pay for language: a resolution of the central paradox in the origin of the species. Brain Res. Rev. 31:118–129CrossRefGoogle Scholar
  18. Davatzikos C. et al. (2005). Whole-brain morphometric study of schizophrenia revealing a spatially complex set of focal abnormalities. Arch. Gen. Psychiatry 62:1218–1227CrossRefGoogle Scholar
  19. Ellard J. (1987). Did schizophrenia exist before the eighteenth century? Aust. N. Z. J. Psychiatry 21(3):306–318CrossRefGoogle Scholar
  20. Fanous A., Kendler K. (2005). Genetic heterogeneity, modifier genes, and quantitative phenotypes in psychiatric illness: searching for a framework. Mol. Psychiatry 10(1):6–13CrossRefGoogle Scholar
  21. Gottesman I., Gould T. (2003). The endophenotype concept in psychiatry: etymology and strategic intentions. Am. J. Psychiatry 160:636–645CrossRefGoogle Scholar
  22. Hare E. (1988). Schizophrenia as a recent disease. British Journal of Psychiatry 153:521–531Google Scholar
  23. Haslam N. (2000). Psychiatric categories as natural kinds: essentialist thinking about mental disorders. Social Res. 67:1031–1058Google Scholar
  24. Haukka J. et al. (2003). Fertility of patients with schizophrenia, their siblings, and the general population. American Journal of Psychiatry 160(3):460–463CrossRefGoogle Scholar
  25. Heinrichs R. (2001). In search of madness. Schizophrenia and neuroscience. OUP, OxfordGoogle Scholar
  26. Heinrichs R. (2003). Historical origins of schizophrenia: Two early madmen and their illness. Journal of the history of the behavioral sciences 39(4):349–363CrossRefGoogle Scholar
  27. Holden C. (2003). Deconstructing schizophrenia. Science 299:333–335CrossRefGoogle Scholar
  28. Horrobin D. (2001). The Madness of Adam and Eve. How Schizophrenia Shaped Humanity. Bantam Press, LondonGoogle Scholar
  29. Hutchinson G. et al. (1999). Fertility and marital rates in first-onset schizophrenia. Social Psychiatry and Psychiatric Epidemiology 34:617–621CrossRefGoogle Scholar
  30. Huxley J. et al. (1964). Schizophrenia as a genetic morphism. Nature 204:220–221CrossRefGoogle Scholar
  31. Jablensky A. et al. (1992). Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychological Medicine – Monograph Supplement 20:1–97Google Scholar
  32. Jeste D. et al. (1985). Did Schizophrenia Exist Before the Eighteenth Century?. Comprehensive Psychiatry 26(6):493–503CrossRefGoogle Scholar
  33. Joseph J. (2003). The Gene Illusion. Genetic Research in Psychiatry and Psychology Under the Microscope. PCCS Books, Ross-on-WyeGoogle Scholar
  34. Karlsson J. (2001). Mental abilities of male relatives of psychotic patients. Acta Psychiatrica Scandinavica 104:466–468CrossRefGoogle Scholar
  35. Keen T. (1999). Schizophrenia: orthodoxy and heresies. A review of alternative possibilities. Journal of Psychiatric and Mental Health Nursing 6:415–424CrossRefGoogle Scholar
  36. Keller M. and Miller G. 2006. Resolving the paradox of common, harmful, heritable mental disorders: which evolutionary genetic models work best? Behav. Brain. Sci. (in press)Google Scholar
  37. Lane A. et al. (1995). Reproductive behaviour in schizophrenia relative to other mental disorders: evidence for increased fertility in men despite decreased marital rate. Acta Psychiatrica Scandinavica 91(4):222–8Google Scholar
  38. Ledgerwood L. et al. (2003). Genes, germs and schizophrenia. An evolutionary perspective. Perspectives in Biology and Medicine 46(3):317–48CrossRefGoogle Scholar
  39. McGrath J. (2005). Myths and plain truths about schizophrenia epidemiology. Acta Psychiatrica Scandinavica 111(1):4–11CrossRefGoogle Scholar
  40. Meehl P. (1990). Toward an integrated theory of schizotaxia, schizotypy, and schizophrenia. Journal of Personality Disorders 4:1–99Google Scholar
  41. Nanko S., Moridaira J. (1993). Reproductive rates in schizophrenic outpatients. Acta Psychiatrica Scandinavica 87:400–404Google Scholar
  42. Nesse R. (1984). An evolutionary perspective on psychiatry. Comparative Psychiatry 25:575–580CrossRefGoogle Scholar
  43. Nettle D. (2001). Strong Imagination: Madness, Creativity and Human Nature. Oxford University Press, OxfordGoogle Scholar
  44. Nettle D., Clegg H. (2005). Schizotypy, creativity and mating success in humans. Proceedings of the Royal Society B 273:611–615Google Scholar
  45. O'Reilly. et al. 2001. Schizotypy and creativity: an evolutionary connection? Pers. Indiv. Differ. 31:1067–1078Google Scholar
  46. Polimeni J., Reiss J. (2002). How shamanism and group selection may reveal the origins of schizophrenia. Medical Hypotheses 58:244–8CrossRefGoogle Scholar
  47. Sarbin T. (1990). Toward the obsolescence of the schizophrenia hypothesis. The Journal of Mind and Behaviour 11(3):259–284Google Scholar
  48. Srinivasan T., Padmavati R. (1997). Fertility and schizophrenia: evidence for increased fertility in the relatives of schizophrenic patients. Acta Psychiatr. Scand. 95:260–264Google Scholar
  49. Stevens A., Price J. (2000). Prophets, Cults and Madness. Duckworth, LondonGoogle Scholar
  50. Sullivan R., Allen J. (2004). Commentary: Natural selection and schizophrenia. Brain and Behavioral Sciences 27(6):865–6CrossRefGoogle Scholar
  51. Thaker G., Carpenter W. (2001). Advances in schizophrenia. Nature Medicine 7(6):667–671CrossRefGoogle Scholar
  52. Torrey E. (1980). Schizophrenia and civilization. Jason Aronson, New YorkGoogle Scholar
  53. Torrey E. (1987). Prevalence studies in schizophrenia. British Journal of Psychiatry 150:598–608CrossRefGoogle Scholar
  54. Van Os J. et al. (1993). Schizophrenia sans frontières: concepts of schizophrenia among French and British psychiatrists. British Medical Journal 307:489–492CrossRefGoogle Scholar
  55. Waddell C. (1998). Creativity and mental illness: is there a link?. Canadian Journal of Psychiatry 43:166–172Google Scholar

Copyright information

© Springer Science+Business Media, B.V. 2006

Authors and Affiliations

  1. 1.Institute of PhilosophyUniversity of LeuvenLeuvenBelgium

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