Applying Evolutionary Psychiatry in Clinical Practice: A Qualitative Study of Clinicians

Abstract Background Evolutionary psychiatry applies principles of evolutionary biology to explain vulnerability to mental disorders and has been proposed as a valuable addition to psychiatric training. Despite increasing interest, little is known about how clinicians understand and apply evolutionary perspectives in practice. Aims To explore psychiatric trainees’ and consultants’ experiences of evolutionary psychiatry teaching and to examine its perceived relevance to clinical practice and training. Methods A qualitative study was conducted using semi-structured focus groups with psychiatric trainees and consultant psychiatrists attending workshop-based teaching sessions. Three focus groups (N = 18) were conducted. Discussions were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Results Four overarching themes were identified: (1) Conceptual Reframing of Psychiatry, (2) Conceptual Value, Curricular Absence, (3) Tension Between Explanatory Insight and Clinical Utility, and (4) Barriers to Integration Within Training and Practice. Participants described evolutionary psychiatry as providing a coherent explanatory framework that enhanced understanding and formulation, particularly through concepts such as adaptation, trade-offs, and mismatch. However, exposure during training was limited, and participants reported uncertainty regarding its application in day-to-day clinical decision-making. Structural barriers, including curriculum constraints and limited faculty expertise, were compounded by concerns regarding abstraction and potential misapplication. Conclusions Evolutionary psychiatry is experienced by clinicians as conceptually valuable but insufficiently integrated into training and practice. Bridging the gap between explanatory insight and clinical utility will require embedding evolutionary perspectives within existing curricula, linking theory to clinically relevant applications, and supporting faculty development.