ReviewPsychological medicine2016
Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder.
Review in Psychological medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 2 of them syntheses that pooled it.
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Who cites it
72 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- System dynamics modelling methods for public health policy evaluation: a systematic literature review focussing on mental health and substance use disorders.BMC public health · 2026Pooled it
- A System Dynamics Simulation Applied to Healthcare: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Aerobic Exercise and Subthreshold Depressive Symptoms in Adolescents: Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2026Trial
- Diagrams-to-Dynamics (D2D): Exploring causal loop diagram leverage points under uncertainty.BMC medicine · 2026Article
- System dynamics of preadolescent mental wellbeing: A multi-actor perspective in Amsterdam using systems archetypes.Journal of public health research · 2026Article
- The Young Adult Sleep model: an evolving causal loop diagram of mental health dynamics.BMC medicine · 2026Article
- Detailed Review of Melatonin and its Role in Managing the Symptoms of Depression.Current molecular medicine · 2026Review
- The Potential of Personalized Post-Traumatic Stress Disorder Networks.Psychiatry and clinical psychopharmacology · 2025Article
- Article
- Exploring the longitudinal relationships between non-suicidal self-injury and depressive symptoms in adolescents: a cross-lagged panel network analysis.BMC psychiatry · 2025Article
- The place of the social in psychiatry: from structural determinants to the ecology of mind.Social psychiatry and psychiatric epidemiology · 2025Review
- Integration of large-scale community-developed causal loop diagrams: a Natural Language Processing approach to merging factors based on semantic similarity.BMC public health · 2025Article
- Pharmacological Mechanism and Drug Research Prospects of Ginsenoside Rb1 as an Antidepressant.Antioxidants (Basel, Switzerland) · 2025Review
- The psychological mechanism of Self-objectification: the interaction between sociocultural pressures and the self-system.Frontiers in psychology · 2025Review
- Gender Difference in the Onset of Adolescent Depressive Symptoms: A Cross-Lagged Panel Network Analysis.Research on child and adolescent psychopathology · 2025Article
- Social anxiety prediction model for nursing students based on machine learning: a cross-sectional survey.Frontiers in psychiatry · 2025Article
- To Use or Not to Use: Exploring Therapists' Experiences with Pre-Treatment EMA-Based Personalized Feedback in the TheraNet Project.Administration and policy in mental health · 2025Article
- Emotion Regulation Difficulties as a Mediator Between Relationship Satisfaction Predicting Depressive Symptom Trajectories Among Couples in Couple Therapy.Behavioral sciences (Basel, Switzerland) · 2024Article
- Analysis of how a complex systems perspective is applied in studies on socioeconomic inequalities in health and health behaviour-a call for reporting guidelines.Health research policy and systems · 2024Article
- Polysaccharides fromHeliyon · 2024Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundDepression 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.
methodWe 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.
resultsThe 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.
conclusionsFuture 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.