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J R Soc Med. 2001 November; 94(11): 601–602.
PMCID: PMC1282254

The Madness of Adam and Eve: How Schizophrenia Shaped Humanity

Reviewed by Roland Littlewood

David Horrobin
275 pp. Price £18.99 ISBN 0-593-04649-8 (h/b)
London: Bantam Press/ Transworld Publishers, 2001 .

That there is an association between insanity and exceptional achievement has often been suggested. Nietzsche observed that ‘it seems impossible to be an artist without being diseased’, whilst J R Nisbet's The Insanity of Genius actually argued ‘The greater the genius the greater the unsoundness’. Nisbet was enthusiastically cited by William James in his monumental study of religious conversion and innovation, whilst the psychiatrist Henry Maudsley, no romantic aesthete he, wondered ‘what right have we to believe Nature under any obligation to do her work by means of complete minds only? She may find an incomplete mind a more suitable instrument for a particular purpose’.

Maudsley turned against the fashionable Victorian eugenics precisely for this reason—that associated with radical creativity there was often a touch, or more, of frank insanity, and by preventing the latter we might lose the former. Take a list of authors of such a book series as the ‘Modern Masters’: it will be evident that more than the expected total (around 2% of the general population) of these have had a serious psychotic illness; or a first-degree relative who has. And, since Karlsson, we know that the relatives of psychotic Europeans have more than an expected figure for achievement in creative pursuits, loosely defined.

David Horrobin postulates an evolutionary inheritance of schizophrenia to back his theory of the nutritional causation of this illness. His argument? That a mutation in proto-hominids around five million years ago allowed fat to be taken up more efficiently by the brain and subcutaneous tissue. The essential fatty acids necessary for optimal brain functioning were to be found in riverine areas (as fish, molluscs, insects, reptile eggs, larvae and crustaceans) and became more accessible to us with our useful bipedal gait: we became fat and hairless, and later, bone-marrow eating as we gained a further mutation predisposing us to dyslexia and schizotypy (a schizoid personality—perverse, idiosyncratic and individualistic). Further mutations around 100 000 years ago, related to the phospholipase A2 cycle, gave us the potential for bipolar disorder, frank schizophrenia and psychopathy (which are associated in families). And creativity? Frank psychosis was initially avoided by a water-based diet rich in the fatty acids required by the brain, and what were then only attenuated psychoses proved apt to fuel human religion, symbolism and art, as well as giving us rather single-minded leaders and the potential for pastoralism and agriculture and thus a more sedentary lifestyle: which ultimately led to the Industrial Revolution and its diet, now with large quantities of saturated fats but a reduction in the range and amounts of essential fatty acids and other micronutrients. And thence the explosion of psychosis in the modern world, the genetic mutation no longer kept within bounds by adequate nutrition.

As Horrobin himself admits, this does sound like yet another ‘just so story’ of evolutionary psychiatry. But let's test it out. It has certain advances on the usual ‘paleolithic genes in the modern world’ tales of lost innocence—for instance, in the emphasis on partial stages of psychosis, the likely polygenic associations of schizophrenia, the correlation with abnormal phospholipid chemistry in the psychoses, and the apparent increase of schizophrenia in the modern world. And not least for the association between the single-mindedness and abhorrent creativity of the schizophrenic experience and our customary expectations in others of distanced cruelty, abstract rationality, the tendency to ethnic differentiation and consequent hatred, our readiness to accept messianic and psychopathic leaders, and our constant need for novelty and curiosity. In fact our whole fractured humanity.

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press