Anthropological and Evolutionary Concepts of Mental Disorders

Patients suffering from mental disorders are often not treated on an equal basis with patients suffering from organic diseases. In Germany, for example, alcohol-dependent patients will be detoxifi ed on a clinical ward to ensure that they survive acute alcohol withdrawal; however, medical insurances often do not cover treatment costs for a therapy for the addictive behavior that underlies the acute alcohol problem. While patients suffering from diabetes mellitus can also display personally harmful choices and, for example, consume sugar although they know that this is detrimental for their health, medical insurances pay for the acute hyperglycemic shock treatment as well as for dietary and medical treatment of the underlying disorder, diabetes mellitus. Not so in alcoholism, where emergency treatment for delirium tremens (a form of severe alcohol withdrawal) will be covered but not psychosocial and medical treatment for the addiction itself. Problems of stigmatization and discrimination obviously play a role in this context. However, nicotine addiction is an example that clearly shows that the disease status of mental disorders itself is controversial—Is nicotine