Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis
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...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
Cambridge University Press
2025
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| Online Access: | http://hdl.handle.net/20.500.11937/97405 |
| _version_ | 1848766260679016448 |
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| author | Yisma, Engida Muyambi, Kuda Walsh, Sandra Othman, Shwikar Gray, Richard Tan, Kuan Liung Steen, Mary Jones, Martin |
| author_facet | Yisma, Engida Muyambi, Kuda Walsh, Sandra Othman, Shwikar Gray, Richard Tan, Kuan Liung Steen, Mary Jones, Martin |
| author_sort | Yisma, Engida |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:48:19Z |
| format | Journal Article |
| id | curtin-20.500.11937-97405 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:48:19Z |
| publishDate | 2025 |
| publisher | Cambridge University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-974052025-05-23T05:15:06Z Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis Yisma, Engida Muyambi, Kuda Walsh, Sandra Othman, Shwikar Gray, Richard Tan, Kuan Liung Steen, Mary Jones, Martin 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. 2025 Journal Article http://hdl.handle.net/20.500.11937/97405 10.1192/bjo.2024.870 English http://creativecommons.org/licenses/by/4.0/ Cambridge University Press fulltext |
| spellingShingle | Yisma, Engida Muyambi, Kuda Walsh, Sandra Othman, Shwikar Gray, Richard Tan, Kuan Liung Steen, Mary Jones, Martin Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| title | Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| title_full | Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| title_short | Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| title_sort | efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis |
| url | http://hdl.handle.net/20.500.11937/97405 |