Hunt Adam D, St-John Smith Paul, Abed Riadh
Institute for Evolutionary Medicine, University of Zürich, Zürich, Switzerland.
Evolutionary Psychiatry Special Interest Group, Royal College of Psychiatrists, London, UK.
Evol Med Public Health. 2022 Nov 22;11(1):67-77. doi: 10.1093/emph/eoac041. eCollection 2023.
The biopsychosocial model remains the de facto framework of current healthcare, but lacks causational depth, scientific rigour, or any recognition of the importance of evolutionary theory for understanding health and disease. In this article it is updated to integrate Tinbergen's four questions with the three biopsychosocial levels. This 'evobiopsychosocial' schema provides a more complete framework for understanding causation of medical conditions. Its application is exemplified by tabulating depression, rheumatoid arthritis and COVID-19 within its format, which highlights the direct research and practical applications uniquely offered by evolutionary medicine. An evobiopsychosocial framework can serve as a useful tool to introduce evolutionary concepts into mainstream medicine by highlighting the broad and specific contributions of evolutionary analysis to researching, treating and preventing health conditions, providing a suitable next step for the mainstream model of medicine.
生物心理社会模型仍然是当前医疗保健的实际框架，但缺乏因果深度、科学严谨性，也未认识到进化理论对理解健康与疾病的重要性。在本文中，它被更新以将廷伯根的四个问题与生物心理社会的三个层次相结合。这种“进化生物心理社会”模式为理解医疗状况的病因提供了一个更完整的框架。通过在其框架内将抑郁症、类风湿性关节炎和新冠肺炎制成表格来说明其应用，这突出了进化医学独特提供的直接研究和实际应用。一个进化生物心理社会框架可以作为一个有用的工具，通过强调进化分析对研究、治疗和预防健康状况的广泛和具体贡献，将进化概念引入主流医学，为医学的主流模式提供合适的下一步发展方向。
