Efficacy and moderators of cognitive therapy versus behavioural activation for adults with depression: study protocol of a systematic review and meta-analysis of individual participant data

E. Driessen, Z.D. Cohen, L. Lorenzo-Luaces, S.D. Hollon, D.A. Richards, K.S. Dobson, S. Dimidjian, J. Delgadillo, F.L. Vázquez, K. McNamara, J.J. Horan, P. Gardner, T.P. Oei, A.H.P. Mehta, J.W.R. Twisk, I.A. Cristea, P. Cuijpers

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.Background Cognitive therapy and behavioural activation are both widely applied and effective psychotherapies for depression, but it is unclear which works best for whom. Individual participant data (IPD) meta-analysis allows for examining moderators at the participant level and can provide more precise effect estimates than conventional meta-analysis, which is based on study-level data. Aims This article describes the protocol for a systematic review and IPD meta-analysis that aims to compare the efficacy of cognitive therapy and behavioural activation for adults with depression, and to explore moderators of treatment effect. (PROSPERO: CRD42022341602) Method Systematic literature searches will be conducted in PubMed, PsycINFO, EMBASE and the Cochrane Library, to identify randomised clinical trials comparing cognitive therapy and behavioural activation for adult acute-phase depression. Investigators of these trials will be invited to share their participant-level data. One-stage IPD meta-analyses will be conducted with mixed-effects models to assess treatment effects and to examine various available demographic, clinical and psychological participant characteristics as potential moderators. The primary outcome measure will be depressive symptom level at treatment completion. Secondary outcomes will include post-treatment anxiety, interpersonal functioning and quality of life, as well as follow-up outcomes. Conclusions To the best of our knowledge, this will be the first IPD meta-analysis concerning cognitive therapy versus behavioural activation for adult depression. This study has the potential to enhance our knowledge of depression treatment by using state-of-the-art statistical techniques to compare the efficacy of two widely used psychotherapies, and by shedding more light on which of these treatments might work best for whom.
Original languageEnglish
Article numbere154
JournalBJPsych Open
Volume8
Issue number5
DOIs
Publication statusPublished - 10 Sept 2022

Funding

E.D. reports a grant from the Netherlands Organization of Scientific Research (NWO) during the conduct of the study. Z.D.C. previously held stock options in Joyable and AbleTo, which he received as compensation for advice on the clinical content of a digital cognitive therapy. S.D. reports being a co-founder of Mindful Noggin, Inc. and receiving revenue from MindfulNoggin.com, receiving royalties related to work on behavioural activation and mindfulness-based cognitive therapy, and funding from philanthropic foundations and the National Institute of Health. I.A.C. is an Editorial Board Member for BJPsych Open, but did not have any involvement in the review process. All other authors have nothing to disclose. This work was supported by the Netherlands Organization of Scientific Research (grant number 016.Veni.195.215 6806 to E.D.); the National Institutes of Health (grant number KL2TR002530 to L.L.-L., and Sheri Robb, Principal Investigator); National Center for Advancing Translational Sciences and Clinical and Translational Sciences Award (grant number UL1TR002529 to L.L.-L., Sharon Moe and Sarah Wiehe, co-Principal Investigators). The funders had no role in the development of this study protocol, nor was there editorial direction or censorship from the sponsors in this manuscript.

FundersFunder number
National Center for Advancing Translational Sciences and Clinical and Translational SciencesUL1TR002529
National Institutes of HealthKL2TR002530
Nederlandse Organisatie voor Wetenschappelijk Onderzoek.195.215 6806, 016

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