Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder
Depression is a complex public health problem with considerable variation in treatment response. The systemic complexity of depression, or the feedback processes among diverse drivers of the disorder, contribute to the persistence of depression. This paper extends prior attempts to understand the co...
| Main Authors: | , , , |
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| Other Authors: | |
| Format: | Article |
| Language: | en_US |
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Cambridge University Press
2017
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| Online Access: | http://hdl.handle.net/1721.1/111133 https://orcid.org/0000-0002-2784-9042 |
| _version_ | 1826203373269942272 |
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| author | Wittenborn, A. K. Rick, J. Hosseinichimeh, N. Rahmandad, Hazhir |
| author2 | Sloan School of Management |
| author_facet | Sloan School of Management Wittenborn, A. K. Rick, J. Hosseinichimeh, N. Rahmandad, Hazhir |
| author_sort | Wittenborn, A. K. |
| collection | MIT |
| description | Depression is a complex public health problem with considerable variation in treatment response. The systemic complexity of depression, or the feedback processes among diverse drivers of the disorder, contribute to the persistence of depression. This paper extends prior attempts to understand the complex causal feedback mechanisms that underlie depression by presenting the first broad boundary causal loop diagram of depression dynamics.
We applied qualitative system dynamics methods to map the broad feedback mechanisms of depression. We used a structured approach to identify candidate causal mechanisms of depression in the literature. We assessed the strength of empirical support for each mechanism and prioritized those with support from validation studies. Through an iterative process, we synthesized the empirical literature and created a conceptual model of major depressive disorder.
The literature review and synthesis resulted in the development of the first causal loop diagram of reinforcing feedback processes of depression. It proposes candidate drivers of illness, or inertial factors, and their temporal functioning, as well as the interactions among drivers of depression. The final causal loop diagram defines 13 key reinforcing feedback loops that involve nine candidate drivers of depression.
Future research is needed to expand upon this initial model of depression dynamics. Quantitative extensions may result in a better understanding of the systemic syndrome of depression and contribute to personalized methods of evaluation, prevention and intervention. |
| first_indexed | 2024-09-23T12:35:53Z |
| format | Article |
| id | mit-1721.1/111133 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T12:35:53Z |
| publishDate | 2017 |
| publisher | Cambridge University Press |
| record_format | dspace |
| spelling | mit-1721.1/1111332022-09-28T08:55:26Z Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder Wittenborn, A. K. Rick, J. Hosseinichimeh, N. Rahmandad, Hazhir Sloan School of Management Rahmandad, Hazhir Depression is a complex public health problem with considerable variation in treatment response. The systemic complexity of depression, or the feedback processes among diverse drivers of the disorder, contribute to the persistence of depression. This paper extends prior attempts to understand the complex causal feedback mechanisms that underlie depression by presenting the first broad boundary causal loop diagram of depression dynamics. We applied qualitative system dynamics methods to map the broad feedback mechanisms of depression. We used a structured approach to identify candidate causal mechanisms of depression in the literature. We assessed the strength of empirical support for each mechanism and prioritized those with support from validation studies. Through an iterative process, we synthesized the empirical literature and created a conceptual model of major depressive disorder. The literature review and synthesis resulted in the development of the first causal loop diagram of reinforcing feedback processes of depression. It proposes candidate drivers of illness, or inertial factors, and their temporal functioning, as well as the interactions among drivers of depression. The final causal loop diagram defines 13 key reinforcing feedback loops that involve nine candidate drivers of depression. Future research is needed to expand upon this initial model of depression dynamics. Quantitative extensions may result in a better understanding of the systemic syndrome of depression and contribute to personalized methods of evaluation, prevention and intervention. National Institute of Mental Health (U.S.) (Award R21MH100515) 2017-09-05T19:54:03Z 2017-09-05T19:54:03Z 2017-09-05 Article http://purl.org/eprint/type/JournalArticle 0033-2917 1469-8978 http://hdl.handle.net/1721.1/111133 Wittenborn, A. K. et al. “Depression as a Systemic Syndrome: Mapping the Feedback Loops of Major Depressive Disorder.” Psychological Medicine 46, 3 (December 2015): 551–562. © 2015 Cambridge University Press https://orcid.org/0000-0002-2784-9042 en_US http://dx.doi.org/10.1017/s0033291715002044 Psychological Medicine Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf Cambridge University Press Prof. Rahmandad via Shikha Sharma |
| spellingShingle | Wittenborn, A. K. Rick, J. Hosseinichimeh, N. Rahmandad, Hazhir Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder |
| title | Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder |
| title_full | Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder |
| title_fullStr | Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder |
| title_full_unstemmed | Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder |
| title_short | Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder |
| title_sort | depression as a systemic syndrome mapping the feedback loops of major depressive disorder |
| url | http://hdl.handle.net/1721.1/111133 https://orcid.org/0000-0002-2784-9042 |
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