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Depression is predicted to be a leading cause of morbidity in 2030 worldwide and in high-income countries

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Evolutionary principles applied to medical practice: key points

  • Medical practice is primarily concerned with preventing and managing ill-health. In turn, this requires an understanding of the determinants of individual phenotype and the factors that lead to variation in disease risk.
  • Understanding why one person develops disease while another does not is improved by considering the evolutionary pathways to altered risk.
  • The human phenotype at any age is a construct of inheritance and the consequences of developmental plasticity, itself informed by environmental history, and is defined further by the interaction with the current physical, biological and social environments.
  • Selection operates to maximise inclusive reproductive fitness, not heath and not longevity.
  • Nothing in the human phenotype was selected for a higher purpose. Most traits are present because they were selected for some adaptive advantage in the past.


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