Ecological Psychiatry/Neuropsychiatry: Is it the Right Time for its Revival?

Dear Editors,

Ecology generally refers to the relationships of an organism with its environment. There are natural and anthropogenic environmental hazards and challenges (climate changes, droughts, cyclones, storms, heat waves, ionizing and non-ionizing radiation, chemicals, biological factors, social cataclysms and wars, natural and man-made disasters etc.), and also spiritual ones (social, psychological, educational, cultural, ethical, religious, etc). All these factors have been demonstrated to affect wellbeing, as well physical and mental health. One of the latest examples in this regard is represented by climate changes that represent unique challenges in the history of humanity, given our ability to computer-model future climate change and its risks. (Moffic 2008, Moran 2013).

Ecological psychiatry/neuropsychiatry or ecopsychiatry/econeuropsychiatry is the application of ecological thought to the study and practice of psychiatry/neuropsychiatry. The term was coined in the late 1970s by the American Psychiatric Association (APA) by relating the environment to mental health and disorders (Chowdhury 2016). The past heyday of ecopsychiatry seemed to arrive only in the mid 1990s, when Ante Lundberg chaired a symposium on this topic at the 1994 APA annual meeting, and subsequently in 1998 served as editor of the book entitled “The Environment and Mental Health”. After two decades of decreasing interest in this topic, nowadays, the time seems ripe for a revival of the ecopsychiatry/ econeuropsychiatry concepts (Krasnov 2002), as gene-environment interactions and epigenetic changes are considered crucial in our understanding of mechanisms of different psychopathology (Bulbena-Cabre et al. 2018). Epidemiologic and genetic studies suggest common environmental and genetic risk factors for a number of psychiatric disorders, including depression, bipolar disorder, and schizophrenia (Matosin et al. 2018). It is believed that adverse environmental factors can induce congenital defects, impair normal neurodevelopment, trigger endogenous mental diseases with their genetical predisposition, as well as evoke psychosomatic and somato-neurologic (somatopsychic) disorders. Interestingly, symptoms caused by exposure to toxins can overlap those caused by fear, stress and depression, and the clinical pictures can mimic a variety of other mental disorders (Lundberg 1998). Therefore, it is urgent that psychiatry takes into account the challenges constituted by the environment in its broader sense, by incorporating ecological concepts in both research projects, and educational programs of current and future psychiatrists.