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    Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis

    Access Status
    In process
    Authors
    Yisma, Engida
    Muyambi, Kuda
    Walsh, Sandra
    Othman, Shwikar
    Gray, Richard
    Tan, Kuan Liung
    Steen, Mary
    Jones, Martin
    Date
    2025
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Yisma, E. and Muyambi, K. and Walsh, S. and Othman, S. and Gray, R. and Tan, K.L. and Steen, M. et al. 2025. Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis. BJPsych Open. 11 (2): pp. 1-12.
    Source Title
    BJPsych Open
    DOI
    10.1192/bjo.2024.870
    Additional URLs
    https://www.cambridge.org/core/journals/bjpsych-open/article/efficacy-and-safety-of-behavioural-activation-on-depression-in-people-with-cooccurring-noncommunicable-diseases-systematic-review-and-metaanalysis/1F613DB72F1BF0F09C8BE0985DBCCB87
    ISSN
    2056-4724
    Faculty
    Faculty of Health Sciences
    School
    Curtin School of Nursing
    URI
    http://hdl.handle.net/20.500.11937/97405
    Collection
    • Curtin Research Publications
    Abstract

    Background People with non-communicable diseases (NCDs) have a higher prevalence of comorbid depression than the general population. While previous research has shown that behavioural activation is effective for general depression, its efficacy and safety in treating depression associated with NCDs remains unclear.

    Aims To compare the efficacy and safety of behavioural activation against comparators in reducing depression symptoms in people with NCDs.

    Method We searched six databases from inception until 30 March 2023 (updated 23 September 2024) for randomised controlled trials (RCTs) comparing behavioural activation with comparators for depression in people with NCDs. Risk of bias was assessed using the Cochrane Collaboration’s ‘risk-of-bias 2 tool’. We calculated a random-effects, inverse-variance weighting meta-analysis.

    Results Of the 21 386 initial studies, 12 RCTs (with 2144 patients) comparing behavioural activation with any comparator on treatment outcomes for depression with comorbid NCD met the inclusion criteria. Six studies rated as low risk of bias. For short-term follow-ups (up to 6 months), meta-analysis showed behavioural activation had little effect on depression symptom improvement in people with NCDs (Hedges’ g = −0.24; 95% CI, −0.62 to 0.15), compared to comparators, with high heterogeneity (I2 = 91.91%). Of the 12 included studies, three RCTs provided data on adverse events occurring during the trial.

    Conclusions Evidence from this systematic review is not sufficient to draw clear conclusions about the efficacy and safety of behavioural activation for reducing depression symptoms in people with NCDs. Future reviews need to include more high-quality, well-designed RCTs to better understand the potential benefits of behavioural activation for comorbid depression.

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