Fecundity of Patients With Schizophrenia, Autism, Bipolar Disorder, Depression, Anorexia Nervosa, or Substance Abuse vs Their Unaffected Siblings

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Abstract
Psychiatric disorders have long puzzled researchers by defying the expectations of natural selection.1 From an evolutionary viewpoint, selection should remove genetic variants that reduce an individual's ability to reproduce (“fitness”) because they will produce fewer offspring to inherit those variants. However, psychiatric disorders do not fit this model. They combine substantial heritability with moderate to high prevalence, early age at onset, and reduction in fitness compared with the general population. Several hypotheses have been put forward on how psychiatric disorders survive in the population,2-5 but the mechanisms that maintain the genetic variants conferring susceptibility to these disorders remain unclear.