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Behavioural Activation for Depression; An Update of Meta-Analysis of Effectiveness and Sub Group Analysis

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  • David Ekers
  • Lisa Webster
  • Annemieke Van Straten
  • Pim Cuijpers
  • David Richards
  • Simon Gilbody

Abstract

Background: 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. Method: 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. Results: 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. Conclusions: 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.

Suggested Citation

  • David Ekers & Lisa Webster & Annemieke Van Straten & Pim Cuijpers & David Richards & Simon Gilbody, 2014. "Behavioural Activation for Depression; An Update of Meta-Analysis of Effectiveness and Sub Group Analysis," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-11, June.
    • Handle: RePEc:plo:pone00:0100100
    DOI: 10.1371/journal.pone.0100100
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    References listed on IDEAS

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    1. Jürgen Barth & Thomas Munder & Heike Gerger & Eveline Nüesch & Sven Trelle & Hansjörg Znoj & Peter Jüni & Pim Cuijpers, 2013. "Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-17, May.
    2. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
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    1. Anett John & Kate Orkin, 2022. "Can Simple Psychological Interventions Increase Preventive Health Investment?," Journal of the European Economic Association, European Economic Association, vol. 20(3), pages 1001-1047.
    2. Emily N Satinsky & Kelly Doran & Julia W Felton & Mary Kleinman & Dwayne Dean & Jessica F Magidson, 2020. "Adapting a peer recovery coach-delivered behavioral activation intervention for problematic substance use in a medically underserved community in Baltimore City," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-19, January.
    3. Carmela Martínez-Vispo & Rubén Rodríguez-Cano & Ana López-Durán & Carmen Senra & Elena Fernández del Río & Elisardo Becoña, 2019. "Cognitive-behavioral treatment with behavioral activation for smoking cessation: Randomized controlled trial," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-20, April.

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