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Welcome to the Henry Stewart Talks lecture about evolution and mental disorders.
At first blush, it might appear that this topic is peripheral.
Mental disorders seem to some people to be somehow different from medical disorders.
In fact, they are different but not because they're less severe or less prevalent.
In fact, they are more severe and more prevalent accounting for
more disease burden than all the rest of medical disorders combined,
at least for people of reproductive ages in developed countries.
But there's another reason why evolution is so important for psychiatry.
Psychiatry has tried to become as biological as possible in the past 20 years,
but in doing so, it skipped much of the biology that has been so useful to medicine.
An evolutionary approach may help to rectify this situation.
The progress in psychiatry over the past two decades is nothing short of spectacular.
In the late 1960s and early 1970s,
there was some thought that perhaps
psychiatry didn't really need to be a part of medicine.
Psychotherapy was in its ascendancy and
the effective drugs for treating mental disorders were just being used widely.
But with the new discovery of drugs and
recognition of their utility in combination with insurance
and other forces that made psychiatry try to quickly
establish itself as just as medical as the rest of medicine,
the profession decided to be as biological as possible and as medical as possible.
It has succeeded tremendously and patients have benefited.
Psychiatry now has more evidence based science than most other areas of medicine,
and in fact it's enormously more effective than it was just 20 years ago.
Most syndromes can be relieved at least to some degree,
and diagnosis is vastly more reliable than it was when I
began in the profession 30 years ago and most remarkable of all,
we're beginning to understand the neural mechanisms that account for disease and even the
mechanisms that account for the normal regulation of emotions and behavior.