Last week I attended the workshop “Darwin in Medicine: Why evolution is relevant
for research and medical practice” in Erice, Sicily, and gave a presentation titled "Evobiopsychosocial Medicine".
This was the submitted abstract:
The biopsychosocial model is the de facto framework of current healthcare. We introduce a new schema for integrating it with evolutionary considerations, applying Tinbergen’s four questions across the three biopsychosocial levels. This ‘Evobiopsychosocial’ (EBPS) schema provides a more complete framework for understanding causation of medical conditions, directing research programs and clinical solutions; the multiple levels of analysis encouraged by the biopsychosocial model are given greater depth by referencing evolutionary causation. We exemplify the application of such a schema by tabulating depression, rheumatoid arthritis and COVID-19 within this EBPS framework, and considering how evolutionary perspectives enhance medical responses to these conditions in different ways. Such tabulations highlight the implications of evolutionary medicine, recognising practical applications of an evolutionary analysis at biological, psychological and social levels, for example by constraining medical research to specific animal models, explaining psychological reactions to illness or directing public health measures. We propose that such tabulations and the EBPS concept more generally could serve as a useful tool for smoothly introducing evolutionary concepts into mainstream medical education. Where the utility of evolutionary medicine is underappreciated but the biopsychosocial model widely recognised, the EBPS provides a fuller model for understanding health and disease, both in research and practise, connecting medicine to biological theory, and clearly demonstrating the added theoretical and practical value of evolutionary medicine.
I have uploaded the presentation slides on the open science framework: https://osf.io/uwpvn/ and aim to have a pre-print available there in coming months.
Thanks to Paul St-John Smith and Riadh Abed, who I co-authored a chapter with on the biopsychosocial model in 2020, which was the inspiration for this paper. Also thanks to Gerhard Medicus (who was present in Erice!) who inspired a tabulation central to the paper (and presentation).
This was my second time (and hopefully not the last) in Erice, and it was beautiful and fun, again. Cheers to everyone who made it - especially those individuals who I have been communicating and collaborating with since the pandemic begun, but had never met. A couple of photos seem appropriate!
Presenting Evobiopsychosocial Medicine
From left: Me, Gillian Pepper, Pierpaolo Merola, Alfonso Troisi and Stefano Parmigiani. Coming out of a long lunch to find cloudy cobbled streets!
Pierpaolo and I, enjoying meeting after years of communication and shared excitement at the field!