Evolutionary theory and the treatment of depression: It is all about the squids and the sea bass.

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Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 376 words

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Keywords Depression; Evolved adaptation; Cognitive behavior therapy; Enduring effect; Antidepressant medications; Iatrogenic effect Highlights * Depression may be an adaptation that evolved to facilitate solving complex problems. * In melancholic depression energy is directed to the brain to facilitate rumination. * Antidepressants may suppress symptoms in a manner that increases risk for relapse. * Cognitive therapy's enduring effect may be an artifact of differential mortality. * Placebo needed to see if antidepressants iatrogenic or cognitive therapy enduring. Abstract According to the analytical rumination hypothesis, depression is an evolved adaptation (like pain or anxiety) that served in our ancestral past to keep people focused on complex interpersonal problems until they could arrive at a resolution (spontaneous remission). If this is true, then those clinical treatments that most facilitate the functions that depression evolved to serve are likely to be more advantageous in the long run than others that simply relieve distress. For example, antidepressant medications may be efficacious in the treatment of depression but only work for so long as they are taken. They may also have an iatrogenic effect that prolongs the duration of the underlying episode. Cognitive and behavioral interventions are as efficacious as medications in terms of reducing acute distress and also appear to have an enduring effect that protects against the return of subsequent symptoms. However, the bulk of the evidence for this effect comes from comparisons to prior medication treatment and it remains unclear whether these psychosocial interventions are truly preventative, or antidepressant medications iatrogenic. A study is described that could resolve this issue and test evolutionary theory with respect to the purported role of rumination in bringing about spontaneous remission. Author Affiliation: (a) Department of Psychology, Vanderbilt University, USA (b) Department of Psychology, Neuroscience, and Behaviour, McMaster University, Canada (c) Sinai Health & Department of Psychiatry, University of Toronto, Canada (d) Centre for Addiction and Mental Health, Canada (e) Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Canada * Corresponding author. Department of Psychology, Vanderbilt University, Nashville, TN, 37203, USA. Article History: Received 30 October 2020; Revised 21 February 2021; Accepted 15 March 2021 Byline: Steven D. Hollon [steven.d.hollon@vanderbilt.edu] (a,*), Paul W. Andrews (b), Daisy R. Singla (c), Marta M. Maslej (d), Benoit H. Mulsant (e)

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Gale Document Number: GALE|A665686085