Is behavioural activation effective in the treatment of depression in young people? A systematic review and meta-analysis

Purpose. Depression is currently the leading cause of illness and disability in young
people. Evidence suggests that behavioural activation (BA) is an effective treatment for
depression in adults but less research focuses on its application with young people. This
review therefore examined whether BA is effective in the treatment of depression in
young people.
Methods. A systematic review (International Prospective Register of Systematic
Reviews reference: CRD42015020453), following Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines, was conducted to examine studies
that had explored behavioural interventions for young people with depression. The
electronic databases searched included the Cochrane Library, EMBASE, MEDLINE,
CINAHL Plus, PsychINFO, and Scopus. A meta-analysis employing a generic inverse
variance, random-effects model was conducted on the included randomized controlled
trials (RCTs) to examine whether there were overall effects of BA on the Children’s
Depression Rating Scale – Revised.
Results. Ten studies met inclusion criteria: three RCTs and seven within-participant
designs (total n = 170). The review showed that BA may be effective in the treatment of
depression in young people. The Cochrane risk of bias tool and the Moncrieff scale used
to assess the quality of the included studies revealed a variety of limitations within each.
Conclusions. Despite demonstrating that BA may be effective in the treatment of
depression in young people, the review indicated a number of methodological problems in
the included studies meaning that the results and conclusions should be treated with
caution. Furthermore, the paucity of studies in this area highlights the need for further
research.