The Black Dog Institute’s hierarchical model and the MAP – a clinically useful model of depression and the online tool to support it.
Over the last 20 years clinicians and researchers at Sydney’s Black Dog Institute, led by Professor Gordon Parker, have developed a model of depression that is more useful in guiding the management of patients with depressive illness than the traditional unitary model. The model is based on the premise that not all depression is the same. The hierarchical model suggests that we are not dealing with different intensities of the same illness but different subtypes of illness, each with different presentations based on personality style and with different levels of contribution from the many aetiological factors that drive depressive illness from the whole biopsychosocial spectrum.
The optimal treatment for each subtype is different. The model provides a rational framework for management decision making, whether the choices be pharmacological or otherwise, and is easy to apply even at a primary care level. The online Mood Assessment Program (MAP), launched in mid 2010 after extensive validation, provides easy access to a suite of instruments that gives practitioners a vast amount of information about their patient, including reliable guidance about the likely sub-type of depression and the appropriate management strategies
