An adaptationist perspective on the etiology of depression

摘要: Major depressive disorder (MDD) presents with a variety of symptoms and responds to wide range treatment interventions. Diagnostic criteria collapse multiple syndromes distinct etiologies into the same disorder. MDD is typically understood as malfunction neurotransmission or brain circuitry regulating mood, pleasure reward, executive function. However, research from an evolutionary perspective suggests that "normal" functioning adaptations may also generate meeting diagnostic criteria. Functioning be underappreciated etiological pathway MDD. Many adaptive functions for have been suggested: biasing cognition avoid losses, conserving energy, disengaging unobtainable goals, signaling submission, soliciting resources, promoting analytical thinking. We review potential role these how they can lead specific clusters symptoms. Understanding such reduces heterogeneity cases help select best intervention each patient. discuss implications different maladaptive pathways use antidepressants various modes psychotherapy. In particular, instances caused by benefit most treatments support function, target precipitating causal stressor. conclude approach study one more promising approaches reduce its better match patients treatment.