Cochrane · systematic review · CD013305
Behavioural activation therapy for depression in adults
Uphoff, E, Ekers, D, Robertson, L, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
49
current version
GRADE rated
48
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 1 · 2%Very low 10 · 20.4%Low 21 · 42.9%Moderate 16 · 32.7%High 1 · 2%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Behavioural activation compared with CBT for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacyup to 6 months (5‐16 weeks) Behavioural activation vs CBT | RR 0.99 [0.92, 1.07] | 5 studies · 601 participants | Moderate Downgraded: risk of bias |
treatment acceptability up to 6 months (4‐16 weeks) Behavioural activation vs CBT | RR 1.03 [0.85, 1.25] | 12 studies · 1195 participants | Low Downgraded: risk of bias, imprecision |
depression symptoms (continuous) up to 6 months (4‐16 weeks) Behavioural activation vs CBT | no estimate extracted | 16 studies · 1205 participants | Moderate Downgraded: risk of bias, imprecision |
quality of life (continuous)up to 6 months (12‐16 weeks) Behavioural activation vs CBT | no estimate extracted | 2 studies · 268 participants | Moderate Downgraded: risk of bias, imprecision |
social adjustment and functioning (continuous)up to 6 months (12 weeks) Behavioural activation vs CBT | no estimate extracted | 2 studies · 111 participants | Very low Downgraded: risk of bias, imprecision |
anxiety symptoms (continuous) up to 6 months (4‐16 weeks) Behavioural activation vs CBT | no estimate extracted | 4 studies · 646 participants | Moderate Downgraded: risk of bias, imprecision |
adverse events (16 weeks) Behavioural activation vs CBT | no estimate extracted | 2 studies · 398 participants | Moderate Downgraded: risk of bias, imprecision |
Behavioural activation compared with third‐wave CBT for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacy up to 6 months (4‐8 weeks) Behavioural activation vs third‐wave CBT | RR 1.1 [0.91, 1.33] | 2 studies · 98 participants | Low Downgraded: risk of bias |
treatment acceptability up to 6 months (4‐8 weeks) Behavioural activation vs third‐wave CBT | RR 0.84 [0.33, 2.1] | 3 studies · 147 participants | Low Downgraded: risk of bias, imprecision |
depression symptoms (continuous) up to 6 months (4‐8 weeks) Behavioural activation vs third‐wave CBT | no estimate extracted | 3 studies · 147 participants | Low Downgraded: risk of bias, imprecision |
quality of life (continuous)up to 6 months (8 weeks) Behavioural activation vs third‐wave CBT | no estimate extracted | 1 study · 81 participants | Low Downgraded: risk of bias, imprecision |
anxiety symptoms (continuous)up to 6 months (4‐8 weeks) Behavioural activation vs third‐wave CBT | no estimate extracted | 3 studies · 147 participants | Low Downgraded: risk of bias, imprecision |
Behavioural activation compared with humanistic therapy for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacyup to 6 months (8‐10 weeks) Behavioural activation vs humanistic therapy | RR 1.84 [1.15, 2.95] | 2 studies · 46 participants | Low Downgraded: risk of bias, imprecision |
treatment acceptabilityup to 6 months (2‐10 weeks) Behavioural activation vs humanistic therapy | RR 1.06 [0.2, 5.55] | 2 studies · 96 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
depression symptoms(continuous) up to 6 months (2‐10 weeks) Behavioural activation vs humanistic therapy | no estimate extracted | 3 studies · 93 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
quality of life (continuous)up to 6 months (2 weeks) Behavioural activation vs humanistic therapy | no estimate extracted | 1 study · 50 participants | Low Downgraded: risk of bias, imprecision, indirectness |
anxiety symptoms (continuous)up to 6 months (2 weeks) Behavioural activation vs humanistic therapy | no estimate extracted | 1 study · 50 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Behavioural activation compared with psychodynamic for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacy up to 6 months (12 weeks) Behavioural activation vs psychodynamic | RR 1.21 [0.74, 1.99] | 1 study · 60 participants | Very low Downgraded: risk of bias |
depression symptoms(continuous) up to 6 months (12 weeks) Behavioural activation vs psychodynamic | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
social adjustment and functioning(continuous) up to 6 months (12 weeks) Behavioural activation vs psychodynamic | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
Behavioural activation compared with interpersonal, cognitive analytic, integrative for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment acceptabilityup to 6 months (4‐12 weeks) Behavioural activation vs interpersonal, cognitive analytic, integrative | RR 0.84 [0.32, 2.2] | 4 studies · 123 participants | Very low Downgraded: risk of bias, imprecision |
depression symptoms (continuous) up to 6 months (4‐12 weeks) Behavioural activation vs interpersonal, cognitive analytic, integrative | no estimate extracted | 4 studies · 103 participants | Very low Downgraded: risk of bias, imprecision |
social adjustment and functioning (continuous)up to 6 months (12 weeks) Behavioural activation vs interpersonal, cognitive analytic, integrative | no estimate extracted | 1 study · 39 participants | Very low Downgraded: risk of bias, imprecision |
anxiety symptoms (continuous) up to 6 months (4 weeks) Behavioural activation vs interpersonal, cognitive analytic, integrative | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision |
adverse events(12 weeks) Behavioural activation vs interpersonal, cognitive analytic, integrative | no estimate extracted | 1 study · 24 participants | Low Downgraded: risk of bias, imprecision |
Behavioural activation compared with waiting list for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacyup to 6 months (4 weeks) Behavioural activation vs waiting list | RR 2.14 [0.9, 5.09] | 1 study · 26 participants | Low Downgraded: risk of bias, imprecision |
treatment acceptabilityup to 6 months (1 to 10 weeks) Behavioural activation vs waiting list | RR 1.17 [0.7, 1.93] | 8 studies · 359 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
depression symptoms(continuous) up to 6 months (1 to 10 weeks) Behavioural activation vs waiting list | no estimate extracted | 12 studies · 619 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
quality of life (continuous)up to 6 months (8 weeks) Behavioural activation vs waiting list | no estimate extracted | 1 study · 80 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
anxiety symptoms(continuous) up to 6 months (4‐12 weeks) Behavioural activation vs waiting list | no estimate extracted | 5 studies · 424 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
adverse events(6 weeks) Behavioural activation vs waiting list | no estimate extracted | 0 studies · 1 participants | Ungraded |
Behavioural activation compared with placebo for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment acceptabilityup to 6 months (16 weeks) Behavioural activation vs placebo | RR 0.72 [0.31, 1.67] | 1 study · 96 participants | Low Downgraded: risk of bias, imprecision |
depression symptoms(continuous) up to 6 months (2 weeks) Behavioural activation vs placebo | no estimate extracted | 2 studies · 108 participants | Low Downgraded: risk of bias, imprecision |
adverse events(16 weeks) Behavioural activation vs placebo | no estimate extracted | 1 study · 96 participants | Low Downgraded: risk of bias, imprecision |
Behavioural activation compared with medication for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacy up to 6 months (16 weeks) Behavioural activation vs medication | RR 1.77 [1.14, 2.76] | 1 study · 141 participants | Moderate Downgraded: risk of bias, imprecision |
treatment acceptabilityup to 6 months (12‐16 weeks) Behavioural activation vs medication | RR 0.52 [0.23, 1.16] | 2 studies · 243 participants | Moderate Downgraded: risk of bias, imprecision |
depression symptoms(continuous) up to 6 months (12‐16 weeks) Behavioural activation vs medication | no estimate extracted | 2 studies · 180 participants | Low Downgraded: risk of bias, imprecision |
adverse events(16 weeks) Behavioural activation vs medication | no estimate extracted | 1 study · 143 participants | Moderate Downgraded: risk of bias, imprecision |
Behavioural activation compared with no treatment for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment acceptabilityup to 6 months (2‐5 weeks) Behavioural activation vs no treatment | RR 0.97 [0.45, 2.09] | 3 studies · 187 participants | Moderate Downgraded: risk of bias |
depression symptoms(continuous) up to 6 months (2‐5 weeks) Behavioural activation vs no treatment | no estimate extracted | 3 studies · 187 participants | Moderate Downgraded: risk of bias, imprecision |
quality of life (continuous)up to 6 months (5 weeks) Behavioural activation vs no treatment | no estimate extracted | 1 study · 118 participants | High |
anxiety symptoms(continuous) up to 6 months (2 weeks) Behavioural activation vs no treatment | no estimate extracted | 1 study · 30 participants | Low Downgraded: risk of bias, imprecision |
Behavioural activation compared with treatment as usual for depression in adults
Population: depression in adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
treatment efficacyup to 6 months (5‐12 weeks) Behavioural activation vs treatment | RR 1.4 [1.1, 1.79] | 7 studies · 1533 participants | Moderate Downgraded: risk of bias |
treatment acceptabilityup to 6 months (5‐12 weeks) Behavioural activation vs treatment | RR 1.64 [0.81, 3.31] | 14 studies · 2518 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
depression symptoms (continuous) up to 6 months (5‐12 weeks) Behavioural activation vs treatment | no estimate extracted | 15 studies · 2208 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
quality of life (continuous)up to 6 months (8‐12 weeks) Behavioural activation vs treatment | no estimate extracted | 6 studies · 1299 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
social adjustment and functioning (continuous)up to 6 months (12 weeks) Behavioural activation vs treatment | no estimate extracted | 2 studies · 88 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
anxiety symptoms(continuous) up to 6 months (8‐12 weeks) Behavioural activation vs treatment | no estimate extracted | 4 studies · 1063 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
adverse events(8‐10 weeks) Behavioural activation vs treatment | no estimate extracted | 3 studies · 1471 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |