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Meta-Analysis
. 2014 Jun 17;9(6):e100100.
doi: 10.1371/journal.pone.0100100. eCollection 2014.

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

David Ekers  1 , Lisa Webster  2 , Annemieke Van Straten  3 , Pim Cuijpers  3 , David Richards  4 , Simon Gilbody  5
Affiliations
Meta-Analysis

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

David Ekers et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flowchart of study inclusion.
Figure 2
Figure 2. Behavioural Activation vs. control post treatment (ordered by effect size high to low).
Figure 3
Figure 3. Behavioural Activation vs. Antidepressant medication.
See this image and copyright information in PMC

References

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