Abstract：
In the last decade, no other branch of clinical pharmacology has been subject to as much criticism of failed innovation and unsatisfactory effectiveness as psychopharmacology. Evolutionary psychiatry can offer original insights on the problems that complicate pharmacological research. Considering that invalid phenotyping is a major obstacle to drug development, an evolutionary perspective suggests targeting clinical phenotypes related to evolved behavior systems because they are more likely to map onto the underlying biology than constructs based on predetermined diagnostic criteria. Because of their emphasis on symptom remission, pharmacological studies of psychiatric populations rarely include functional capacities as the primary outcome measure and neglect the impact of social context on the effects of psychiatric drugs. Evolutionary psychiatry explains why it is appropriate to replace symptoms with functional capacities as the primary target of psychiatric therapies and why social context should be a major focus of studies assessing the effectiveness of drugs currently used and new drugs under development. When the focus of research shifts to those questions that go beyond the \"disease-based\" concept of drug action, evolutionary psychiatry clearly emerges as a reference framework to assess drug effectiveness and to optimize clinicians\' decisions about prescribing, deprescribing, and non-prescribing.
摘要：
在过去的十年里，没有其他临床药理学分支像精神药理学那样受到对创新失败和效果不令人满意的批评.进化精神病学可以为复杂的药理学研究提供原始见解。考虑到无效的表型是药物开发的主要障碍，进化论的观点表明,靶向与进化行为系统相关的临床表型,因为与基于预定诊断标准的构建体相比,它们更有可能映射到基础生物学上.因为他们强调症状缓解，精神病学人群的药理学研究很少将功能能力作为主要结果指标，而忽略了社会背景对精神药物效果的影响。进化精神病学解释了为什么用功能能力代替症状作为精神病治疗的主要目标是合适的，以及为什么社会背景应该是评估当前使用的药物和正在开发的新药有效性的研究的主要焦点。当研究的重点转移到那些超出“基于疾病”的药物作用概念的问题时，进化精神病学显然成为评估药物有效性和优化临床医生处方决策的参考框架，开药,和非处方。
