Behavioural activation therapy for depression in adults

Eleonora Uphoff, David Ekers, Lindsay Robertson, Sarah Dawson, Emily Sanger, Emily South, Zainab Samaan, David Richards, Nicholas Meader, Rachel Churchill, Eleonora Uphoff, David Ekers, Lindsay Robertson, Sarah Dawson, Emily Sanger, Emily South, Zainab Samaan, David Richards, Nicholas Meader, Rachel Churchill

Abstract

Background: Behavioural activation is a brief psychotherapeutic approach that seeks to change the way a person interacts with their environment. Behavioural activation is increasingly receiving attention as a potentially cost-effective intervention for depression, which may require less resources and may be easier to deliver and implement than other types of psychotherapy.

Objectives: To examine the effects of behavioural activation compared with other psychological therapies for depression in adults. To examine the effects of behavioural activation compared with medication for depression in adults. To examine the effects of behavioural activation compared with treatment as usual/waiting list/placebo no treatment for depression in adults.

Search methods: We searched CCMD-CTR (all available years), CENTRAL (current issue), Ovid MEDLINE (1946 onwards), Ovid EMBASE (1980 onwards), and Ovid PsycINFO (1806 onwards) on the 17 January 2020 to identify randomised controlled trials (RCTs) of 'behavioural activation', or the main elements of behavioural activation for depression in participants with clinically diagnosed depression or subthreshold depression. We did not apply any restrictions on date, language or publication status to the searches. We searched international trials registries via the World Health Organization's trials portal (ICTRP) and ClinicalTrials.gov to identify unpublished or ongoing trials.

Selection criteria: We included randomised controlled trials (RCTs) of behavioural activation for the treatment of depression or symptoms of depression in adults aged 18 or over. We excluded RCTs conducted in inpatient settings and with trial participants selected because of a physical comorbidity. Studies were included regardless of reported outcomes.

Data collection and analysis: Two review authors independently screened all titles/abstracts and full-text manuscripts for inclusion. Data extraction and 'Risk of bias' assessments were also performed by two review authors in duplicate. Where necessary, we contacted study authors for more information.

Main results: Fifty-three studies with 5495 participants were included; 51 parallel group RCTs and two cluster-RCTs. We found moderate-certainty evidence that behavioural activation had greater short-term efficacy than treatment as usual (risk ratio (RR) 1.40, 95% confidence interval (CI) 1.10 to 1.78; 7 RCTs, 1533 participants), although this difference was no longer evident in sensitivity analyses using a worst-case or intention-to-treat scenario. Compared with waiting list, behavioural activation may be more effective, but there were fewer data in this comparison and evidence was of low certainty (RR 2.14, 95% CI 0.90 to 5.09; 1 RCT, 26 participants). No evidence on treatment efficacy was available for behavioural activation versus placebo and behavioural activation versus no treatment. We found moderate-certainty evidence suggesting no evidence of a difference in short-term treatment efficacy between behavioural activation and CBT (RR 0.99, 95% CI 0.92 to 1.07; 5 RCTs, 601 participants). Fewer data were available for other comparators. No evidence of a difference in short term-efficacy was found between behavioural activation and third-wave CBT (RR 1.10, 95% CI 0.91 to 1.33; 2 RCTs, 98 participants; low certainty), and psychodynamic therapy (RR 1.21, 95% CI 0.74 to 1.99; 1 RCT,60 participants; very low certainty). Behavioural activation was more effective than humanistic therapy (RR 1.84, 95% CI 1.15 to 2.95; 2 RCTs, 46 participants; low certainty) and medication (RR 1.77, 95% CI 1.14 to 2.76; 1 RCT; 141 participants; moderate certainty), but both of these results were based on a small number of trials and participants. No evidence on treatment efficacy was available for comparisons between behavioural activation versus interpersonal, cognitive analytic, and integrative therapies. There was moderate-certainty evidence that behavioural activation might have lower treatment acceptability (based on dropout rate) than treatment as usual in the short term, although the data did not confirm a difference and results lacked precision (RR 1.64, 95% CI 0.81 to 3.31; 14 RCTs, 2518 participants). Moderate-certainty evidence did not suggest any difference in short-term acceptability between behavioural activation and waiting list (RR 1.17, 95% CI 0.70 to 1.93; 8 RCTs. 359 participants), no treatment (RR 0.97, 95% CI 0.45 to 2.09; 3 RCTs, 187 participants), medication (RR 0.52, 95% CI 0.23 to 1.16; 2 RCTs, 243 participants), or placebo (RR 0.72, 95% CI 0.31 to 1.67; 1 RCT; 96 participants; low-certainty evidence). No evidence on treatment acceptability was available comparing behavioural activation versus psychodynamic therapy. Low-certainty evidence did not show a difference in short-term treatment acceptability (dropout rate) between behavioural activation and CBT (RR 1.03, 95% CI 0.85 to 1.25; 12 RCTs, 1195 participants), third-wave CBT (RR 0.84, 95% CI 0.33 to 2.10; 3 RCTs, 147 participants); humanistic therapy (RR 1.06, 95% CI 0.20 to 5.55; 2 RCTs, 96 participants) (very low certainty), and interpersonal, cognitive analytic, and integrative therapy (RR 0.84, 95% CI 0.32 to 2.20; 4 RCTs, 123 participants). Results from medium- and long-term primary outcomes, secondary outcomes, subgroup analyses, and sensitivity analyses are summarised in the text.

Authors' conclusions: This systematic review suggests that behavioural activation may be more effective than humanistic therapy, medication, and treatment as usual, and that it may be no less effective than CBT, psychodynamic therapy, or being placed on a waiting list. However, our confidence in these findings is limited due to concerns about the certainty of the evidence. We found no evidence of a difference in short-term treatment acceptability (based on dropouts) between behavioural activation and most comparison groups (CBT, humanistic therapy, waiting list, placebo, medication, no treatment or treatment as usual). Again, our confidence in all these findings is limited due to concerns about the certainty of the evidence. No data were available about the efficacy of behaioural activation compared with placebo, or about treatment acceptability comparing behavioural activation and psychodynamic therapy, interpersonal, cognitive analytic and integrative therapies. The evidence could be strengthened by better reporting and better quality RCTs of behavioural activation and by assessing working mechanisms of behavioural activation.

Conflict of interest statement

Eleonora Uphoff: no conflicts of interest

David Ekers, in his role of Chief Investigator, is responsible for the conduct of the ongoing CHEMIST and MODS trials in which behavioural activation therapies are evaluated. He is a Co‐Investigator of the included CASPER trial and the author of several publications reporting on trials of behavioural activation.

Lindsay Robertson: no conflicts of interest

Sarah Dawson: no conflicts of interest

Emily Sanger: no conflicts of interest

Emily South: no conflicts of interest

Zainab Samaan: no conflicts of interest

David Richards has been involved in several trials of behavioural activation, including in his role as Chief Investigator of the UK National Institute for Health Research funded COBRA and CADET trials. He has published extensively on the subject of behavioural activation in peer reviewed journals and clinical text books.

Nicholas Meader: no conflicts of interest

Rachel Churchill leads and has responsibility for Cochrane Common Mental Disorders, which has supported parts of the review process and is largely funded by a grant from the National Institute of Health and Research (NIHR) in the UK.

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
4
4
Funnel plot of comparison: 6 behavioural activation vversus waiting list, outcome: 6.3 depression symptoms.
1.1. Analysis
1.1. Analysis
Comparison 1: behavioural activation vs CBT, Outcome 1: treatment efficacy
1.2. Analysis
1.2. Analysis
Comparison 1: behavioural activation vs CBT, Outcome 2: treatment acceptability (dropouts)
1.3. Analysis
1.3. Analysis
Comparison 1: behavioural activation vs CBT, Outcome 3: depression symptoms
1.4. Analysis
1.4. Analysis
Comparison 1: behavioural activation vs CBT, Outcome 4: quality of life
1.5. Analysis
1.5. Analysis
Comparison 1: behavioural activation vs CBT, Outcome 5: social adjustment and functioning
1.6. Analysis
1.6. Analysis
Comparison 1: behavioural activation vs CBT, Outcome 6: anxiety symptoms
2.1. Analysis
2.1. Analysis
Comparison 2: behavioural activation vs third‐wave CBT, Outcome 1: treatment efficacy
2.2. Analysis
2.2. Analysis
Comparison 2: behavioural activation vs third‐wave CBT, Outcome 2: treatment acceptability (dropouts)
2.3. Analysis
2.3. Analysis
Comparison 2: behavioural activation vs third‐wave CBT, Outcome 3: depression symptoms
2.4. Analysis
2.4. Analysis
Comparison 2: behavioural activation vs third‐wave CBT, Outcome 4: quality of life
2.5. Analysis
2.5. Analysis
Comparison 2: behavioural activation vs third‐wave CBT, Outcome 5: anxiety symptoms
3.1. Analysis
3.1. Analysis
Comparison 3: behavioural activation vs humanistic therapy, Outcome 1: treatment efficacy
3.2. Analysis
3.2. Analysis
Comparison 3: behavioural activation vs humanistic therapy, Outcome 2: treatment acceptability (dropouts)
3.3. Analysis
3.3. Analysis
Comparison 3: behavioural activation vs humanistic therapy, Outcome 3: depression symptoms
3.4. Analysis
3.4. Analysis
Comparison 3: behavioural activation vs humanistic therapy, Outcome 4: quality of life
3.5. Analysis
3.5. Analysis
Comparison 3: behavioural activation vs humanistic therapy, Outcome 5: anxiety symptoms
4.1. Analysis
4.1. Analysis
Comparison 4: behavioural activation vs psychodynamic, Outcome 1: treatment efficacy
4.2. Analysis
4.2. Analysis
Comparison 4: behavioural activation vs psychodynamic, Outcome 2: depression symptoms
4.3. Analysis
4.3. Analysis
Comparison 4: behavioural activation vs psychodynamic, Outcome 3: social adjustment and functioning
5.1. Analysis
5.1. Analysis
Comparison 5: behavioural activation vs interpersonal, cognitive analytic, integrative, Outcome 1: treatment acceptability (dropouts)
5.2. Analysis
5.2. Analysis
Comparison 5: behavioural activation vs interpersonal, cognitive analytic, integrative, Outcome 2: depression symptoms
5.3. Analysis
5.3. Analysis
Comparison 5: behavioural activation vs interpersonal, cognitive analytic, integrative, Outcome 3: social adjustment and functioning
5.4. Analysis
5.4. Analysis
Comparison 5: behavioural activation vs interpersonal, cognitive analytic, integrative, Outcome 4: anxiety symptoms
6.1. Analysis
6.1. Analysis
Comparison 6: behavioural activation vs waiting list, Outcome 1: treatment efficacy
6.2. Analysis
6.2. Analysis
Comparison 6: behavioural activation vs waiting list, Outcome 2: treatment acceptability (dropouts)
6.3. Analysis
6.3. Analysis
Comparison 6: behavioural activation vs waiting list, Outcome 3: depression symptoms
6.4. Analysis
6.4. Analysis
Comparison 6: behavioural activation vs waiting list, Outcome 4: quality of life
6.5. Analysis
6.5. Analysis
Comparison 6: behavioural activation vs waiting list, Outcome 5: anxiety symptoms
7.1. Analysis
7.1. Analysis
Comparison 7: behavioural activation vs placebo, Outcome 1: treatment acceptability (dropouts)
7.2. Analysis
7.2. Analysis
Comparison 7: behavioural activation vs placebo, Outcome 2: depression symptoms
8.1. Analysis
8.1. Analysis
Comparison 8: behavioural activation vs medication, Outcome 1: treatment efficacy
8.2. Analysis
8.2. Analysis
Comparison 8: behavioural activation vs medication, Outcome 2: treatment acceptability (dropouts)
8.3. Analysis
8.3. Analysis
Comparison 8: behavioural activation vs medication, Outcome 3: depression symptoms
9.1. Analysis
9.1. Analysis
Comparison 9: behavioural activation vs no treatment, Outcome 1: treatment acceptability (dropouts)
9.2. Analysis
9.2. Analysis
Comparison 9: behavioural activation vs no treatment, Outcome 2: depression symptoms
9.3. Analysis
9.3. Analysis
Comparison 9: behavioural activation vs no treatment, Outcome 3: quality of life
9.4. Analysis
9.4. Analysis
Comparison 9: behavioural activation vs no treatment, Outcome 4: anxiety symptoms
10.1. Analysis
10.1. Analysis
Comparison 10: behavioural activation vs treatment as usual, Outcome 1: treatment efficacy
10.2. Analysis
10.2. Analysis
Comparison 10: behavioural activation vs treatment as usual, Outcome 2: treatment acceptability (dropouts)
10.3. Analysis
10.3. Analysis
Comparison 10: behavioural activation vs treatment as usual, Outcome 3: depression symptoms
10.4. Analysis
10.4. Analysis
Comparison 10: behavioural activation vs treatment as usual, Outcome 4: quality of life
10.5. Analysis
10.5. Analysis
Comparison 10: behavioural activation vs treatment as usual, Outcome 5: social adjustment and functioning
10.6. Analysis
10.6. Analysis
Comparison 10: behavioural activation vs treatment as usual, Outcome 6: anxiety symptoms
11.1. Analysis
11.1. Analysis
Comparison 11: SUBGROUP 1 AGE behavioural activation vs other controls (up to 6 months), Outcome 1: treatment efficacy
11.2. Analysis
11.2. Analysis
Comparison 11: SUBGROUP 1 AGE behavioural activation vs other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
12.1. Analysis
12.1. Analysis
Comparison 12: SUBGROUP 2 THERAPIST behavioural activation vs other psychological therapies (up to 6 months), Outcome 1: treatment efficacy
12.2. Analysis
12.2. Analysis
Comparison 12: SUBGROUP 2 THERAPIST behavioural activation vs other psychological therapies (up to 6 months), Outcome 2: treatment acceptability (dropouts)
13.1. Analysis
13.1. Analysis
Comparison 13: SUBGROUP 2 THERAPIST behavioural activation vs other controls (up to 6 months), Outcome 1: treatment efficacy
13.2. Analysis
13.2. Analysis
Comparison 13: SUBGROUP 2 THERAPIST behavioural activation vs other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
14.1. Analysis
14.1. Analysis
Comparison 14: SUBGROUP 3 SEVERITY behavioural activation vs other controls (up to 6 months), Outcome 1: treatment efficacy
14.2. Analysis
14.2. Analysis
Comparison 14: SUBGROUP 3 SEVERITY behavioural activation vs other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
15.1. Analysis
15.1. Analysis
Comparison 15: SUBGROUP 4 LENGTH behavioural activation vs other controls (up to 6 months), Outcome 1: treatment acceptability (dropouts)
16.1. Analysis
16.1. Analysis
Comparison 16: SUBGROUP 5 THERAPY behavioural activation vs other psychological therapies (up to 6 months), Outcome 1: treatment efficacy
16.2. Analysis
16.2. Analysis
Comparison 16: SUBGROUP 5 THERAPY behavioural activation vs other psychological therapies (up to 6 months), Outcome 2: treatment acceptability (dropouts)
17.1. Analysis
17.1. Analysis
Comparison 17: SUBGROUP 6 CONTROL behavioural activation vs other controls (up to 6 months), Outcome 1: treatment efficacy
17.2. Analysis
17.2. Analysis
Comparison 17: SUBGROUP 6 CONTROL behavioural activation vs other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
18.1. Analysis
18.1. Analysis
Comparison 18: SENSITIVITY 1 HIGH QUALITY STUDIES behavioural activation versus other psychological therapies (up to 6 months), Outcome 1: treatment efficacy
18.2. Analysis
18.2. Analysis
Comparison 18: SENSITIVITY 1 HIGH QUALITY STUDIES behavioural activation versus other psychological therapies (up to 6 months), Outcome 2: treatment acceptability (dropouts)
19.1. Analysis
19.1. Analysis
Comparison 19: SENSITIVITY 2 HIGH QUALITY STUDIES behavioural activation versus other controls (up to 6 months), Outcome 1: treatment efficacy
19.2. Analysis
19.2. Analysis
Comparison 19: SENSITIVITY 2 HIGH QUALITY STUDIES behavioural activation versus other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
20.1. Analysis
20.1. Analysis
Comparison 20: SENSITIVITY 3 FACE‐TO‐FACE behavioural activation vs other psychological therapies (up to 6 months), Outcome 1: treatment efficacy
20.2. Analysis
20.2. Analysis
Comparison 20: SENSITIVITY 3 FACE‐TO‐FACE behavioural activation vs other psychological therapies (up to 6 months), Outcome 2: treatment acceptability (dropouts)
21.1. Analysis
21.1. Analysis
Comparison 21: SENSITIVITY 4 FACE‐TO‐FACE behavioural activation vs other controls (up to 6 months), Outcome 1: treatment efficacy
21.2. Analysis
21.2. Analysis
Comparison 21: SENSITIVITY 4 FACE‐TO‐FACE behavioural activation vs other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
22.1. Analysis
22.1. Analysis
Comparison 22: SENSITIVITY 5 INDIVIDUAL behavioural activation versus other psychological therapies (up to 6 months), Outcome 1: treatment efficacy
22.2. Analysis
22.2. Analysis
Comparison 22: SENSITIVITY 5 INDIVIDUAL behavioural activation versus other psychological therapies (up to 6 months), Outcome 2: treatment acceptability (dropouts)
23.1. Analysis
23.1. Analysis
Comparison 23: SENSITIVITY 5 INDIVIDUAL behavioural activation versus other controls (up to 6 months), Outcome 1: treatment efficacy
23.2. Analysis
23.2. Analysis
Comparison 23: SENSITIVITY 5 INDIVIDUAL behavioural activation versus other controls (up to 6 months), Outcome 2: treatment acceptability (dropouts)
24.1. Analysis
24.1. Analysis
Comparison 24: SENSITIVITY 6 fixed effects BA vs waiting list, Outcome 1: depression symptoms
24.2. Analysis
24.2. Analysis
Comparison 24: SENSITIVITY 6 fixed effects BA vs waiting list, Outcome 2: anxiety symptoms
25.1. Analysis
25.1. Analysis
Comparison 25: SENSITIVITY 7 fixed effects BA vs treatment as usual, Outcome 1: depression symptoms
25.2. Analysis
25.2. Analysis
Comparison 25: SENSITIVITY 7 fixed effects BA vs treatment as usual, Outcome 2: quality of life
26.1. Analysis
26.1. Analysis
Comparison 26: MISSING DATA ITT (up to 6 months), Outcome 1: treatment efficacy
27.1. Analysis
27.1. Analysis
Comparison 27: MISSING DATA BEST CASE (up to 6 months), Outcome 1: treatment efficacy
28.1. Analysis
28.1. Analysis
Comparison 28: MISSING DATA WORST CASE (up to 6 months), Outcome 1: treatment efficacy

References

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Carlbring 2013a {published data only}
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Chang 2018 {published data only}
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Chowdhary 2016 {published data only}
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Collado 2016 {published data only}
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    1. NCT01958840. Evaluating behavioral activation efficacy in depressed Spanish-speaking Latinos. (first received 9 October 2013).
Comas Díaz 1981 {published data only}
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Cullen 2003 {published data only}
    1. Cullen JM. Testing the effectiveness of behavioral activation therapy in the treatment of acute unipolar depression [thesis]. Vol. 64. Kalamazoo (US): Western Michigan University, 2003.
Dimidjian 2006 {published data only}
    1. Coffman SJ, Martell CR, Dimidjian S, Gallop R, Hollon SD. Extreme nonresponse in cognitive therapy: can behavioral activation succeed where cognitive therapy fails? Journal of Consulting and Clinical Psychology 2007;75(4):531-41. [DOI: 10.1037/0022-006X.75.4.531]
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    1. Dimidjian SA, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, Addis M, et al. Methods and acute-phase outcomes. In: 157th Annual Meeting of the American Psychiatric Association; 2004 May 1-6; New York. 2004:27A.
    1. Dobson KS, Hollon SD, Dimidjian S, Schmaling KB, Kohlenberg RJ, Gallop RJ, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of Consulting and Clinical Psychology 2008;76(3):468-77. [DOI: ]
    1. Rizvi S, Dimidjian SA, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, et al. Predictiont of treatment response. In: 157th Annual Meeting of the American Psychiatric Association; 2004 May 1-6; New York. 2004:27C.
Ekers 2011 {published data only}
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Fleming 1980 {published data only}
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Fuchs 1977 {published data only}
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Gardner 1981 {published data only}
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Gawrysiak 2009 {published data only}
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Gilbody 2017 {published data only}
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Hemanny 2019 {published data only}
    1. Hemanny C, Carvalho C, Maia N, Reis D, Botelho AC, Bonavides D, et al. Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial. CNS Spectrums 26 Nov 2019;[Epub ahead of print]:1-10. [DOI: 10.1017/S1092852919001457]
Jacobson 1996 {published data only}
    1. Addis ME, Jacobson NS. Reasons for depression and the process and outcome of cognitive-behavioral psychotherapies. Journal of Consulting and Clinical Psychology 1996;64(6):1417-24. [DOI: 10.1037//0022-006x.64.6.1417]
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Kanter 2015 {published data only}
    1. Kanter JW, Santiago-Rivera AL, Rusch LC, Busch AM, West P. Initial outcomes of a culturally adapted behavioral activation for Latinas diagnosed with depression at a community clinic. Behaviour Modification 2010;34(2):120-44. [DOI: 10.1177/0145445509359682]
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    1. Santos MM, Nagy GA, Hurtado GD, West P, Santiago-Rivera AL, Lee HJ, et al. Acculturative stress as a moderator of treatment engagement and retention in behavioral activation and treatment as usual for Latinos with depression. Special Issue: Evidence-Based Treatments With Latinas/os 2017;5(4):275-89. [DOI: 10.1037/lat0000074]
    1. Santos MM. Is the therapeutic alliance associated with and predictive of treatment retention and outcome among Latinos? A secondary analysis of an RCT of behavioral activation for Latinos with depression versus treatment-as-usual [thesis]. Vol. 78. Milwaukee (US): University of Wisconsin-Milwaukee, 2017.
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    1. Kelly FD, Dowd ET, Duffey DK. A comparison of cognitive and behavioural intervention strategies in the treatment of depression. British Journal of Cognitive Psychotherapy 1983;1(2):51-8.
Kornblith 1980 {published data only}
    1. Kornblith SJ. Evaluating the contribution of self reinforcement training and behavioral assignments of the efficacy of self control therapy for depression [thesis]. Dissertation abstracts international 1980;41(1-B):0354-0355 .
Luo 2020 {published data only}
    1. Luo H, Lou VW, Chen C, Chi I. The effectiveness of the positive mood and active life program on reducing depressive symptoms in long-term care facilities. Gerontologist 2020;60(1):193-204. [DOI: 10.1093/geront/gny120]
Ly 2014 {published data only}
    1. Ly KH, Carlbring P, Andersson G. Behavioral activation-based guided self-help treatment administered through a smartphone application: study protocol for a randomized controlled trial. Trials 2012;13:62. [DOI: 10.1186/1745-6215-13-62]
    1. Ly KH, Truschel A, Jarl L, Magnusson S, Windahl T, Johansson R, et al. Behavioural activation versus mindfulness-based guided self-help treatment administered through a smartphone application: a randomised controlled trial. BMJ Open 2014;4(1):e003440. [DOI: 10.1136/bmjopen-2013-003440]
    1. NCT01463020. Behavioural activation-based treatment administered through smartphone [Behavioural activation-based guided self-help treatment administered through a smartphone application]. (first received 19 June 2013).
McCluskey 2018 {published data only}
    1. McCluskey DL. Examining the efficacy of a 1-session brief behavioral activation intervention with university students with mild to moderate depressive symptoms [thesis]. Vol. 79. Morgantown (US): West Virginia University, 2018.
McIndoo 2016 {published data only}
    1. McIndoo CC, File AA, Preddy T, Clark CG, Hopko DR. Mindfulness-based therapy and behavioral activation: a randomized controlled trial with depressed college students. Behaviour Research Therapy 2016;77:118-28. [DOI: 10.1016/j.brat.2015.12.012]
    1. McIndoo CC. Mindfulness-based therapy and behavioral activation: a randomized controlled trial with depressed college students [thesis]. Knoxville (US): University of Tennessee, 2015.
McNamara 1986 {published data only}
    1. McNamara K, Horan JJ. Experimental construct validity in the evaluation of cognitive and behavioral treatments for depression. Journal of Counseling Psychology 1986;33(1):23-30. [DOI: 10.1037/0022-0167.33.1.23]
Meeks 2008 {published data only}
    1. Meeks S, Looney SW, Haitsma K, Teri L. BE-ACTIV: a staff-assisted behavioral intervention for depression in nursing homes. Gerontologist 2008;48(1):105-14. [DOI: 10.1093/geront/48.1.105]
    1. NCT00056485. Treatment of depression in nursing homes [Behavioral intervention for depression in nursing homes]. (first received 13 April 2017).
    1. NCT00536406. Evaluating a behavioral activities treatment program for depressed nursing home residents (BE-ACTIV) [BE-ACTIV: Treating Depression in Nursing Homes]. (first received 13 April 2017).
Moradveisi 2015 {published data only}
    1. IRCT138807192573N1. A randomized controlled trial of behavioral activation and treatment as usual in the acute treatments of adults with major depressive disorder. (first received 16 January 2010).
    1. Moradveisi L, Huibers MJ, Arntz A. The influence of patients' attributions of the immediate effects of treatment of depression on long-term effectiveness of behavioural activation and antidepressant medication. Behaviour Research and Therapy 2015;69:83-92. [DOI: 10.1016/j.brat.2015.04.007]
    1. Moradveisi L, Huibers MJ, Renner F, Arasteh M, Arntz A. "Results for behavioural activation are overstated": Reply. British Journal of Psychiatry 2013;202(6):466-67. [DOI: 10.1192/bjp.202.6.466a]
    1. Moradveisi L, Huibers MJ, Renner F, Arasteh M, Arntz A. Behavioural activation v. antidepressant medication for treating depression in Iran: randomised trial. British Journal of Psychiatry 2013;202(3):204-11. [DOI: 10.1192/bjp.bp.112.113696]
    1. Moradveisi L. Behavioral activation for depressed patients in Iran: Effectiveness, predictors and mediators in the context of a randomized trial [thesis]. Maastricht: Maastricht University, 2015.
Nasrin 2017 {published data only}
    1. Nasrin F, Rimes K, Reinecke A, Rinck M, Barnhofer T. Effects of brief behavioural activation on approach and avoidance tendencies in acute depression: preliminary findings. Behavioural and Cognitive Psychotherapy 2017;45(1):58-72. [DOI: 10.1017/S1352465816000394]
    1. Nasrin F. Investigating mechanisms of behavioural activation for depression [thesis]. London (UK): Kings College London, 2014.
Padfield 1976 {published data only}
    1. Padfield M. The comparative effects of two counseling approaches on the intensity of depression among rural women of low socioeconomic status. Journal of Counseling Psychology 1976;23(3):209-14. [DOI: 10.1037/0022-0167.23.3.209]
Raue 2019 {published data only}
    1. Raue PJ, Sirey JA, Dawson A, Berman J, Bruce ML. Lay‐delivered behavioral activation for depressed senior center clients: Pilot RCT. International Journal of Geriatric Psychiatry 2019;34(11):1715-23. [DOI: 10.1002/gps.5186]
Rehm 1982 {published data only}
    1. Rehm LP, Rabin AS, Kaslow NJ, Willard R. Cognitive and behavioral targets in a self-control therapy program for depression. Association for the Advancement of Behavior Therapy, Los Angeles, CA. November 20 1982.
Richards 2017 {published data only}
    1. Finning K, Richards DA, Moore L, Ekers D, McMillan D, Farrand PA, et al. Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation. BMJ Open 2017;7(4):e014161. [DOI: 10.1136/bmjopen-2016-014161]
    1. HTA. COBRA (Cost and Outcome of Behavioural Activation): a randomised controlled trial of behavioural activation versus cognitive behaviour therapy for depression [HTA - 10/50/14 Protocol]. Health Technology Assessment 2012.
    1. ISRCTN27473954. COBRA: Cost and Outcome of BehaviouRal Activation [COBRA (Cost and Outcome of BehaviouRal Activation): a two-arm Phase III, non-inferiority, patient level, randomised controlled trial of behavioural activation versus cognitive behaviour therapy]. (first received 5 December 2011).
    1. Rhodes S, Richards DA, Ekers D, McMillan D, Byford S, Farrand PA, et al. Cost and outcome of behavioural activation versus cognitive behaviour therapy for depression (COBRA): study protocol for a randomised controlled trial. Trials 2014;15:29. [DOI: 10.1186/1745-6215-15-29]
    1. Richards DA, Ekers D, McMillan D, Taylor RS, Byford S, Warren FC, et al. Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial. Lancet 2016;388(10047):871-80. [DOI: 10.1016/S0140-6736(16)31140-0]
    1. Richards DA, Rhodes S, Ekers D, McMillan D, Taylor RS, Byford S, et al. Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression. Health Technology Assessment 2017;21(46):1-366. [DOI: 10.3310/hta21460]
Shaw 1977 {published data only}
    1. Shaw BF. A systematic investigation of two psychological treatments of depression [thesis]. Vol. 36. London (Canada): Western University, 1976.
    1. Shaw BF. Comparison of cognitive therapy and behavior therapy in the treatment of depression. Journal of Consulting and Clinical Psychology 1977;45(4 CNO - CN-00216117):543-51. [DOI: 10.1037//0022-006x.45.4.543]
Skinner 1984 {published data only}
    1. Skinner DA. Self-control of depression: A comparison of behavior therapy and cognitive behavior therapy [thesis]. Vol. 45. United States International University, 1984.
Stiles‐Shields 2019 {published data only}
    1. Stiles-Shields C, Montague E, Kwasny MJ, Mohr DC. Behavioral and cognitive intervention strategies delivered via coached apps for depression: Pilot trial. Psychological Services 2019;16(2):233-8. [DOI: 10.1037/ser0000261]
Takagaki 2016 {published data only}
    1. Mori A, Okamoto Y, Okada G, Takagaki K, Takamura M, Jinnin R, et al. Effects of behavioural activation on the neural circuit related to intrinsic motivation. British Journal of Psychiatry Open 2018;4(5):317-23. [DOI: 10.1192/bjo.2018.40]
    1. Takagaki K, Jinnin R, Mori A, Nishiyama Y, Yamamura T, Yokoyama S et al. Enduring effects of a 5-week behavioral activation program for subthreshold depression among late adolescents: An exploratory randomized controlled trial. Neuropsychiatric Disease and Treatment 2018;14:2633-41. [DOI: 10.2147/NDT.S172385]
    1. Takagaki K, Jinnin R, Mori A, Nishiyama Y, Yamamura T, Yokoyama S, et al. Behavioral activation for late adolescents with subthreshold depression: a randomized controlled trial. European Child and Adolescent Psychiatry 2016;25(11):1171-82. [DOI: 10.1007/s00787-016-0842-5]
Taylor 1977 {published data only}
    1. Taylor FG, Marshall WL. Experimental analysis of a cognitive-behavioral therapy for depression. Cognitive Therapy and Research 1977;1(1 CNO - CN-00216245):59-72.
Thomas 1987 {published data only}
    1. Thomas JR, Petry RA, Goldman JR. Comparison of cognitive and behavioral self-control treatments of depression. Psychological Reports 1987;60(3, Pt 1):975-82. [DOI: 10.2466/pr0.1987.60.3.975]
Thompson 1987 {published data only}
    1. Smith CA. The comparative effectiveness of psychotherapies for depressed elders: Interaction between individual attributes and therapeutic models [thesis]. Dissertation abstracts international 1995;56(6-B CNO - CN-00711179):3464.
    1. Thompson LW, Gallagher D, Breckenridge JS. Comparative effectiveness of psychotherapies for depressed elders. Journal of Consulting and Clinical Psychology 1987;55(3):385-90. [DOI: 10.1037/0022-006X.55.3.385]
Toghyani 2018 {published data only}
    1. Toghyani M, Kajbaf MB, Amir G. Adherence to Islamic lifestyle as a cost-effective treatment for depression. Mental Health, Religion & Culture 2018;21(8):797-809. [DOI: 10.1080/13674676.2018.1551342]
van den Hout 1995 {published data only}
    1. den Hout JH, Arntz A, Kunkels FH. Efficacy of a self-control therapy program in a psychiatric day-treatment center. Acta Psychiatrica Scandinavica 1995;92(1):25-9. [DOI: 10.1111/j.1600-0447.1995.tb09538.x]
Vázquez 2014 {published data only}
    1. Vázquez FL, Torres A, Ptero P, Blanco V, Diaz O, Estevez LE. Analysis of the components of a cognitive-behavioral intervention administered via conference call for preventing depression among non-professional caregivers: a pilot study. Aging and Mental Health 2017;21(9):938-46. [DOI: 10.1080/13607863.2016.1181714]
Weinberg 1978 {published data only}
    1. Weinberg L. Behaviorally and cognitively oriented approaches to the alleviation of depressive symptoms in college students [thesis]. Dissertation abstracts international 1978;38(7-B):3422-3.
Weobong 2017 {published data only}
    1. Patel V, Weobong B, Weiss HA, Anand A, Bhat B, Katti B, et al. The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial. Lancet 2017;389(10065):176-85. [DOI: 10.1016/S0140-6736(16)31589-6]
    1. Weobong B, Weiss HA, McDaid D, Singla DR, Hollon SD, Nadkarni A, et al. Sustained effectiveness and cost-effectiveness of the Healthy Activity Programme, a brief psychological treatment for depression delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial. PLOS Medicine 2017;14(9):e1002385. [DOI: 10.1371/journal.pmed.1002385]
Wilson 1983 {published data only}
    1. Wilson PH, Goldin JC, Charbonneau-Powis M. Comparative efficacy of behavioral and cognitive treatments of depression. Cognitive Therapy and Research 1983;7(2):111-24.
Xie 2019 {published data only}
    1. Xie J, He G, Ding S, Pan C, Zhang X, Zhou J, et al. A randomized study on the effect of modified behavioral activation treatment for depressive symptoms in rural left-behind elderly. Psychotherapy Research 2019;29(3):372-82. [DOI: 10.1080/10503307.2017.1364444]
Zeiss 1979 {published data only}
    1. Zeiss AM, Lewinsohn PM, Muñoz RF. Nonspecific improvement effects in depression using interpersonal skills training, pleasant activity schedules, or cognitive training. Journal of Consulting and Clinical Psychology 1979;47(3):427-39. [DOI: 10.1037//0022-006x.47.3.427]
Zemestani 2016 {published data only}
    1. Zemestani M, Davoodi I, Honarmand MM, Zargar Y, Ottaviani C. Comparative effects of group metacognitive therapy versus behavioural activation in moderately depressed students. Journal of Mental Health 2016;25(6):479-85. [DOI: 10.3109/09638237.2015.1057326]
References to studies excluded from this review Almeida 2018 {published data only}
    1. Almeida OP. BAN-Dep: a Trial to decrease the prevalence of depression in Australian nursing homes [A randomised control trial of Behavioral activation among older Australians living in nursing homes to treat and prevent depression - The BAN-Dep Trial]. (first received 6 April 2018).
Arjadi 2018a {published data only}
    1. Arjadi R. A step toward bridging the mental health gap using the internet: internet interventions for common mental health disorders in low and middle income countries, and treating depression in Indonesia [thesis]. Groningen: University of Groningen, 2018.
Bagnall 2014 {published data only}
    1. Bagnall KM. Long-term follow-up of NetmumsHWD: a feasibility randomised controlled trial of telephone supported online behavioural activation for postnatal depression at 16 months post-randomisation [thesis]. Exeter (UK): University of Exeter, 2014.
Barrera 1979 {published data only}
    1. Barrera M. An evaluation of a brief group therapy for depression. Journal of Consulting and Clinical Psychology 1979;47(2):413-5. [DOI: 10.1037/0022-006X.47.2.413]
Cernin 2009 {published data only}
    1. Cernin P, Lichtenberg P. Behavioral treatment for depressed mood: A pleasant events intervention for seniors residing in assisted living. Special Issue: Long-term care 2009;32(3):324-31. [DOI: 10.1080/07317110902896547]
Clignet 2012 {published data only}
    1. Clignet F, Meijel B, Straten A, Cuijpers P. The systematic activation method as a nursing intervention in depressed elderly: a protocol for a multi–centre cluster randomized trial. BMC Psychiatry 2012;12:144. [DOI: 10.1186/1471-244X-12-144]
Dimidjian 2017 {published data only}
    1. Dimidjian, S, Goodman SH, Sherwood NE, Simon GE, Ludman E, Gallop R, et al. A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. Journal of Consulting and Clinical Psychology 2017;85(1):26-36. [DOI: 10.1037/ccp0000151]
Egede 2018 {published data only}
    1. Egede LE, Acierno R, Knapp RG, Lejeuz C, Hernandez-Tejada M, Payne EH, et al. Psychotherapy for depression in older veterans via telemedicine: a randomised, open-label, non-inferiority trial. Lancet Psychiatry 2015;2(8):693-701. [DOI: 10.1016/S2215-0366(15)00122-4]
    1. Egede LE, Dismuke CE, Walker RJ, Acierno R, Freuh BC. Cost-effectiveness of behavioral activation for depression in older adult veterans: in-person care versus telehealth. Journal of Clinical Psychiatry 2018;79(5):28. [DOI: 10.4088/JCP.17m11888]
Farrand 2014 {published data only}
    1. Farrand P, Pentecost C, Greaves C, Taylor RS, Warren F, Green C, et al. A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc). Trials 2014;15:196. [DOI: 10.1186/1745-6215-15-196]
Gallagher 1983 {published data only}
    1. Gallagher DE, Thompson LW. Effectiveness of psychotherapy for both endogenous and nonendogenous depression in older adult outpatients. Journals of Gerontology 1983;38(6 CNO - CN-00350623):707-12.
Lambert 2018 {published data only}
    1. Lambert JD, Greaves CJ, Farrand P, Price L, Haase AM, Tahlor AH. Web-based intervention using behavioral activation and physical activity for adults with depression (the eMotion study): pilot randomized controlled trial. Journal of Medical Internet Research 2018;20(7):e10112. [DOI: 10.2196/10112]
    1. Lambert JD. A pilot randomized controlled trial of an intervention for adults with depression: the eMotion study [A pilot randomized controlled trial of a web-based intervention using behavioral activation and physical activity for adults with depression: the eMotion study]. (first received 20 March 2017).
Luxton 2012 {published data only}
    1. Luxton DD. A randomized controlled trial of in-home tele-behavioral health care utilizing behavioral activation for depression. (first received 16 May 2012).
Ly 2015 {published data only}
    1. Ly KH, Topooco N, Cederlund H, Wallin A, Bergstrom J, Molander O, et al. Smartphone-supported versus full behavioural activation for depression: a randomised controlled trial. PLOS One 2015;10(5):e0126559. [DOI: 10.1371/journal.pone.0126559]
Mausbach 2018 {published data only}
    1. Mausbach BT. Mobile web-based behavioral intervention for improving caregiver well-being. (first received 24 April 2018).
McKendree Smith 2000 {published data only}
    1. McKendree-Smith NL. Cognitive and behavioral bibliotherapy for depression: an examination of efficacy and mediators and moderators of change [thesis]. Vol. 60. Tuscaloosa: University of Alabama, 2000.
McLean 1973 {published data only}
    1. McLean PD, Ogston K, Grauer L. A behavioral approach to the treatment of depression. Journal of Behavior Therapy and Experimental Psychiatry 1973;4(4):323-30. [DOI: 10.1016/0005-7916%2873%2990002-5]
McLean 1979 {published data only}
    1. McLean PD, Hakstian AR. Clinical depression: comparative efficacy of outpatient treatments. Journal of Consulting and Clinical Psychology 1979;47(5):818-36.
Moss 2012 {published data only}
    1. Moss K, Scogin F, Di Napoli E, Presnell A. A self-help behavioral activation treatment for geriatric depressive symptoms. Aging & Mental Health 2012;16(5):625-35. [DOI: 10.1080/13607863.2011.651435]
Pentecost 2015 {published data only}
    1. Pentecost C, Farrand P, Greaves CJ, Taylor RS, Warren FC, Hillsdon M, et al. Combining behavioural activation with physical activity promotion for adults with depression: findings of a parallel-group pilot randomised controlled trial (BAcPAc). Trials 2015;16:367. [DOI: 10.1186/s13063-015-0881-0]
Rehm 1981 {published data only}
    1. Rehm LP, Kornblith SJ, O'Hara MW. An evaluation of major components in a self-control therapy program for depression. Behavior Modification 1981;5(4):459-89.
Shapiro 1974 {published data only}
    1. Shapiro MB, Shapiro DA. Experiments on the feeling of depression. British Journal of Social and Clinical Psychology 1974;13(Pt 2):191-9.
Soucy 2018 {published data only}
    1. Soucy I, Provencher M, Fortier M, McFadden T. Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial. Cognitive Behavioral Therapy 2017;46(6):493-506. [DOI: 10.1080/16506073.2017.1337806]
    1. Soucy I, Provencher MD, Fortier M, McFadden T. Secondary outcomes of the guided self-help behavioral activation and physical activity for depression trial. Journal of Mental Health 2018;28(4):410-418. [DOI: 10.1080/09638237.2018.1466031]
Stein 2017 {published data only}
    1. Stein AT. A pilot study of therapist guided activity practice for depressive symptoms. (first received 31 October 2017).
Turner 1979 {published data only}
    1. Turner RW, Ward MF, Turner DJ. Behavioral treatment for depression: an evaluation of therapeutic components. Journal of Clinical Psychology 1979;35(1):166-75.
Watkins 2016 {published data only}
    1. Watkins E, Newbold A, Tester-Jones M, JAvaid M, Cadman J, Collins LM, et al. Implementing multifactorial psychotherapy research in online virtual environments (IMPROVE-2): study protocol for a phase III trial of the MOST randomized component selection method for internet cognitive-behavioural therapy for depression. BMC Psychiatry 2016;16(1):345. [DOI: 10.1186/s12888-016-1054-8]
References to studies awaiting assessment Bolin 1974 {published data only}
    1. Bolin DC, Kivens L. Evaluation in a community mental health center: Huntsville, Alabama. Evaluation: The International Journal of Theory, Research and Practice 1974;2(1):26-35. [PMID: ]
Bollenbach 1983 {published data only}
    1. Bollenbach A. A comparison of three cognitive treatments in alleviating depression. In: 63rd Annual Meeting of the Western Psychological Association, San Francisco, CA, April 6-10. 1983:84.
Central South University {published data only}
    1. The Third Xiangya Hospital of Central South University. A modified behavioral activation treatment for geriatric depressive symptoms in left-behind elderly in rural china. (first received 27 May 2016).
Jalili 2014 {published data only}
    1. Jalili A, Farid AA, Gharaei B, Soleymani M, Parisa F. Effectiveness of group behavioral activation treatment on depressive symptoms and dysfunctional attitudes. Psychological Research 2014;17(1):45-66.
Naeem 2015 {published data only}
    1. Naeem F. Pilot RCT to test effectiveness of the ACE4 (Activity Challenge-4 areas) for depression and anxiety [A pilot RCT to test effectiveness of the ACE4 (Activity Challenge-4 areas) for depression and anxiety: a behavioural activation based game]. (first received 2 September 2015).
Pace 1978 {published data only}
    1. Pace FR. Behavioral techniques in the treatment of depression. Dissertation Abstracts International 1978;39(2-B):0992.
Steffen 1998 {published data only}
    1. Steffen AM, Futterman A, Gallagher-Thompson D. Depressed caregivers: comparative outcomes of two interventions. Clinical Gerontologist 1998;19(4):3-15.
Weiss 2010 {published data only}
    1. Weiss B. Paraprofessional treatment of depression in Vietnam. (first received 3 November 2009).
References to ongoing studies Almeida 2016 {published data only}
    1. Almeida O. The MIRROR2 pilot study: prevention of major depressIon among older people living in regional and remote areas of Western Australia [Randomised controlled trial to determine if a behavioural activation intervention reduces the onset of a Major Depressive Episode in older people with subsyndromal depression living in remote and regional Western Australia]. (first received 5 October 2016).
    1. Almeida OP. The MIRROR1 pilot study: treatMent of depressIon among older people living in Regional and RemOte aReas. (first received 5 October 2016).
Banerjee 2019 {published data only}
    1. Banerjee M. Cognitive control training for depression [Cognitive control training for depression: a randomized controlled trial]. (first received 11 September 2019).
Botella 2015 {published data only}
    1. Botella C, Baños R. Efficacy of two internet delivered intervention programs for depression: behavioral activation vs physical activity (PROMETEOII) [Treatment of depression: efficacy and efficiency of two self-administered online intervention protocols based on behavioral activation and physical activity]. (first received 23 February 2015).
Daphne 2017 {published data only}
    1. Daphne J, Lejeuz CW, Kustanowitz J, Felton J, Diaz VA, Player MS, et al. Moodivate: a self-help behavioral activation mobile app for utilization in primary care-Development and clinical considerations. International Journal of Psychiatric Medicine 2017;52(2):160-75.
    1. Lejuez CW. Development and testing of a behavioral activation mobile therapy for elevated depressive systems. (first received 13 September 2019).
Haynes 2018 {published data only}
    1. Haynes T, Turner J, Smith J, Curran G, Bryant-Moore K, Ounpraseuth ST, et al. Reducing depressive symptoms through behavioral activation in churches: a hybrid-2 randomized effectiveness-implementation design. Contemporary Clinical Trials 2018;64:22-9.
    1. Hutchins EM. Reducing depressive symptoms among rural African Americans (REJOICE) [Reducing depressive symptoms among rural African Americans]. (first received 9 August 2016).
Isometsä 2016 {published data only}
    1. Isometsä E. Effectiveness of add-on group behavioral activation treatment for depression in psychiatric care [Effectiveness of group format behavioral activation treatment for depression or peer support groups added on usual treatment vs treatment as usual for depression in psychiatric care]. (first received 21 October 2016).
Janssen 2017 {published data only}
    1. Janssen N, Huibers MJ, Lucassen P, Voshaar RO, Marwijk H, Bosman J, et al. Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial. BMC Psychiatry 2017;17(1):230.
Massoudi 2017 {published data only}
    1. Massoudi B, Blanker MH, Valen E, Wouters H, Bockting CL, Burger H. Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING]: study protocol of a non-inferiority randomized trial. BMC Psychiatry 2017;17(1):218. [DOI: 10.1186/s12888-017-1376-1]
Ruzickova 2019 {published data only}
    1. Ruzickova T, Murphy S, Harmer C. Effects of behavioural activation on emotional cognition and mood (protocol). Pharmacological Reports 2019;71(6):1313.
Sakai 2017 {published data only}
    1. Sakai M. Randomized controlled trial of behavioral activation group therapy for depression in undergraduate students. (first received 1 November 2017).
Samaan 2014 {published data only}
    1. Chum J, Kim MS, Zielinski L, Bhatt M, Chung D, Yeung S, et al. Acceptability of the Fitbit in beahvioural activation therapy for depression: a qualitative study. Evidence Based Mental Health 2017;20(4):128-33.
    1. Samaan Z. A pilot study to assess the effectiveness of behaviouRal ActiVation Group Program in Patients With dEpression (BRAVE). (first received 27 January 2014).
    1. Samaan Z. A study to assess the effectiveness of behavioural activation group therapy in individuals with depression (BRAVE) [A pragmatic randomized trial to investigate the effectiveness of behavioural activation group therapy in reducing depressive symptoms and improving quality of life in patient with depression: BRAVE Study]. (first received 21 November 2014).
Schaich 2018 {published data only}
    1. Schaich A, Heikaus L, Assmann N, Kohne S, Jauch-Chara K, Huppe M, et al. PRO MDD study protocol: effectiveness of outpatient treatment programs for major depressive disorder: metacognitive therapy vs. behavioral activation a single-center randomized clinical trial. Frontiers in Psychiatry 2018;9:584. [DOI: 10.3389/fpsyt.2018.00584]
University of Pennsylvania 2016 {published data only}
    1. University of Pennsylvania. Feasibility of a behavioral activation trial [Feasibility of a behavioral activation trial in community mental health]. (first received 14 December 2016).
VA Office of Research and Development 2014 {published data only}
    1. VA Office of Research and Development. Improving mood in veterans in primary care [RCT of behavioral activation for depression and suicidality in primary care]. (first received 28 October 2014).
Velasquez Reyes 2019 {published data only}
    1. Velasquez Reyes D, Patel H, Lautenschlager N, Ford A, Curran E, Kelly R et al. Behavioural activation in nursing homes to treat depression (BAN-Dep): study protocol for a pragmatic randomised controlled trial. BMJ Open 2019;9(10):e032421.
Additional references APA 1980
    1. American Psychiatric Association. Diagnostical and Statistical Manual of Mental Disorders (DSM-III). 3rd edition. Washington, DC: American Psychiatric Association, 1980.
APA 1987
    1. American Psychiatric Association. Diagnostical and Statistical Manual of Mental Disorders (DSM-III-R). 3rd edition, revised. Washington, DC: American Psychiatric Association, 1987.
APA 1994
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th edition. Washington, DC: American Psychiatric Association, 1994.
APA 2000
    1. American Psychiatric Association. Diagnostical and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th edition, text revision. Washington, DC: American Psychiatric Association, 2000.
APA 2013
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th edition. Washington, DC: American Psychiatric Association, 2013.
Arroll 2009
    1. Arroll B, Elley CR, Fishman T, Goodyear-Smith FA, Kenealy T, Blashki G, et al. Antidepressants versus placebo for depression in primary care. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD007954]
Barbato 2018
    1. Barbato A, D'Avanzo B, Parabiaghi A. Couple therapy for depression. Cochrane Database of Systematic Reviews 2018, Issue 6. [DOI: 10.1002/14651858.CD004188.pub3]
Beck 1961
    1. Beck AT, Ward CH, Mendelsohn M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561-71.
Beck 1979
    1. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York: Guildford Press, 1979.
Beck 1988
    1. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 1988;56(6):893-7.
Bennett‐Levy 2004
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