Background: From an evolutionary perspective it is remarkable that psychotic
disorders, mostly occurring during fertile age and decreasing fecundity, maintain in the
human population.
Aim: To argue the hypothesis that psychotic symptoms may not be viewed as an illness
but as an adaptation phenomenon, which can become out of control due to different
underlying brain vulnerabilities and external stressors, leading to social exclusion.
Methods: A literature study and analysis.
Results: Until now, biomedical research has not unravelld the definitive etiology of
psychotic disorders. Findings are inconsistent and show non-specific brain anomalies
and genetic variation with small effect sizes. However, compelling evidence was found
for a relation between psychosis and stressful environmental factors, particularly those
influencing social interaction. Psychotic symptoms may be explained as a natural defense
mechanism or protective response to stressful environments. This is in line with the fact
that psychotic symptoms most often develop during adolescence. In this phase of life,
leaving the familiar, and safe home environment and building new social networks is one
of the main tasks. This could cause symptoms of “hyperconsciousness” and calls on the
capacity for social adaptation.
Conclusions: Psychotic symptoms may be considered as an evolutionary maintained
phenomenon.Research investigating psychotic disorders may benefit from a focus on
underlying general brain vulnerabilities or prevention of social exclusion, instead of
psychotic symptoms
