Behavioural activation treatment for depression in individuals with neurological conditions: a systematic review

Oates, Lloyd L.; Moghaddam, Nima; Evangelou, Nikos; das Nair, Roshan

Abstract

© The Author(s) 2019. Objective: To evaluate the effectiveness of behavioural activation interventions for people with neurological conditions with comorbid depression, and explore content and adaptations. Data sources: PsycINFO, MEDLINE, CINAHL, AMED, and EMBASE databases were searched on the 19 November 2019. Reference lists of selected full-texts were screened by title. Review methods: We included peer-reviewed studies published in English that used behavioural activation for treatment of depression in adults with a neurological condition. Single-case reports, reviews, and grey literature were excluded. Methodological quality was assessed by two authors independently, and quality was appraised using Critical Appraisal Skills Programme checklists. Results: From 2714 citations, 10 articles were included comprising 590 participants. Behavioural activation was used to treat depression in people with dementia (n = 4), stroke (n = 3), epilepsy (n = 1), Parkinson’s disease (n = 1), and brain injury (n = 1). Sample size ranged from 4 to 105 participants. There were seven randomized controlled studies; however, no studies compared behavioural activation to an alternative psychological therapy. The effect sizes varied between small and large in the studies where effect size could be calculated (d = 0.24–1.7). Methodological quality of the included studies was variable. Intervention components were identifying and engaging in pleasurable activities, psychoeducation, and problem-solving. Adaptations included delivering sessions via telephone, delivering interventions via primary caregivers, and giving psychoeducation to caregivers. Conclusion: The effectiveness of behavioural activation in randomized controlled trials varied from small to large (d = 0.24–1.7) in reducing depression. The content of behavioural activation was comparable to established treatment manuals. Adaptations appeared to support individuals to engage in therapy. Review registration: PROSPERO 2018, CRD42018102604.

Citation

Oates, L. L., Moghaddam, N., Evangelou, N., & das Nair, R. (2020). Behavioural activation treatment for depression in individuals with neurological conditions: a systematic review. Clinical Rehabilitation, 34(3), 310-319. https://doi.org/10.1177/0269215519896404

• Journal Article Type: Article
• Acceptance Date: Dec 1, 2019
• Online Publication Date: Dec 26, 2019
• Publication Date: Mar 1, 2020
• Deposit Date: Dec 10, 2019
• Publicly Available Date: Jan 3, 2020
• Journal: Clinical Rehabilitation
• Print ISSN: 0269-2155
• Electronic ISSN: 1477-0873
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 34
• Issue: 3
• Pages: 310-319
• DOI: https://doi.org/10.1177/0269215519896404
• Keywords: Neurological conditions, Depression, Behavioural activation, Behavioural therapy, Activity scheduling
• Public URL: https://nottingham-repository.worktribe.com/output/3523852
• Publisher URL: https://journals.sagepub.com/doi/full/10.1177/0269215519896404