From the perspective of anthropological psychiatry, Harland et al (Reference Harland, Morgan and Hutchinson2004) suggest that the social change experienced by migrants may predispose to schizophrenia. The same may apply to other forms of social change, such as those changes which lead to revitalisation phenomena and new religious movements. Psychiatric anthropologists who have studied new religious movements have pointed out that new forms of belief system may originate in the hallucinatory or delusional experience of a single individual (Reference LittlewoodLittlewood, 1984). Wallace (Reference Wallace1956) applied the term ‘mazeway resynthesis’ to the change in belief system which occurs in prophets, the mazeway being to the individual what culture is to society, so that the prophet awakes to a new reality which he or she then tries to impart to followers; if successful, the prophet becomes the leader of a new religious movement; otherwise, he or she is alienated from the parent group and is likely to be labelled as mentally ill. Foulks (Reference Foulks1977) compared the prophet to the patient with schizophrenia, and noted that they shared not only the capacity to undergo a radical change in belief system but also various ‘premorbid’ features.

For many years population geneticists have been surprised that the genetic tendency to schizophrenia is maintained in spite of the reduced fertility of those affected (Reference CrowCrow, 1995). However, the fertility of cult leaders is often increased, owing to increased mating opportunities within the cult, and to the possibility of an ‘adaptive radiation’ in a new land following the inevitable social and geographical alienation of the cult from the parent group. If the genes responsible for schizophrenia and prophetic experience were the same, it is possible that the fecundity of successful cult leaders might balance the loss of genes both in people with schizophrenia and in unsuccessful cult leaders (Reference Price and StevensPrice & Stevens, 1998).

Such evolutionary speculations are independent of the proximal causes of schizophrenia, which might be a neurodevelopmental disorder or might even be part of the extended phenotype of a micro-organism. But they do suggest that if we find something in the brains of our patients, we should ask our psychiatric anthropological colleagues to look for the same thing in the brains of the founders of new religious movements.