Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis

Depression is a common, disabling condition for which psychological treatments are recommended. Behavioural activation has attracted increased interest in recent years. It has been over 5 years since our meta-analyses summarised the evidence supporting and this systematic review updates those findin...

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Bibliographic Details
Published in:PloS one 2014-06, Vol.9 (6), p.e100100-e100100
Main Authors: Ekers, David, Webster, Lisa, Van Straten, Annemieke, Cuijpers, Pim, Richards, David, Gilbody, Simon
Format: Article
Language:English
Subjects:
Antidepressants
Behavior modification
Biology and Life Sciences
Caregivers
Clinical psychology
Clinical trials
Cognition & reasoning
Depression - therapy
Drugs
Female
Humans
Intervention
Male
Medical ethics
Medicine and Health Sciences
Mental depression
Meta-analysis
Moderators
Pharmacy
Psychotherapy
Randomization
Regression analysis
Reviews
Scheduling
Social Sciences
Studies
Systematic review
Therapy
Treatment Outcome
Upgrading
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Summary:Depression is a common, disabling condition for which psychological treatments are recommended. Behavioural activation has attracted increased interest in recent years. It has been over 5 years since our meta-analyses summarised the evidence supporting and this systematic review updates those findings and examines moderators of treatment effect. Randomised trials of behavioural activation for depression versus controls or anti-depressant medication were identified using electronic database searches, previous reviews and reference lists. Data on symptom level and study level moderators were extracted and analysed using meta-analysis, sub-group analysis and meta-regression respectively. Twenty six randomised controlled trials including 1524 subjects were included in this meta-analysis. A random effects meta-analysis of symptom level post treatment showed behavioural activation to be superior to controls (SMD -0.74 CI -0.91 to -0.56, k = 25, N = 1088) and medication (SMD -0.42 CI -0.83 to-0.00, k = 4, N = 283). Study quality was low in the majority of studies and follow- up time periods short. There was no indication of publication bias and subgroup analysis showed limited association between moderators and effect size. The results in this meta-analysis support and strengthen the evidence base indicating Behavioural Activation is an effective treatment for depression. Further high quality research with longer term follow-up is needed to strengthen the evidence base.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0100100