Behavioural Activation for Depression: a systematic review and controlled clinical trial

摘要: Background Depression is a common, disabling condition for which psychological treatments, in particular cognitive behavioural therapies are recommended. Promising results from randomised trials has renewed interest therapy, may be suitable delivery by non-specialist therapists. Aims To deliver phased research programme to examine the clinical and cost effectiveness of therapy depressed adults, suitability intervention non specialists. Research design A systematic review meta-analysis examined treatments depression compared controls or other psychotherapies. Data on symptom level, recovery/dropout rate study level moderators (study quality, number sessions, severity training) were extracted analysed. Based upon controlled trial comparing BA delivered with treatment as usual primary care setting was conducted. Results Meta-Analysis: Seventeen including 1109 subjects included. A post-treatment showed superior (SMD -0.70 CI -1.00 -0.39, k=12, N= 459), brief psychotherapy -0.56 -1.0 to-0.12, k=3, N=166), supportive -0.75 –1.37 -0.14, k=2, N=45) equal 0.08 -0.14 0.30, N=476). Randomised trial: Intention treat analyses indicated difference favour −15.79 (95% −24.55 −7.02) Beck Depression Inventory-II, −11.12; = −17.53 −4.70), Work Social Adjustment Scale 0.20 0.01 0.39) improvement quality adjusted life year. An incremental ratio £5756 per QALY indicates 97% probability that non-specialists more effective than at threshold value £20,000. Conclusion Behavioural Activation an appears non-specialists. Further larger sample sizes longer follow up required expand findings reported this thesis.