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

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

Authors

Lloyd L. Oates

Nima Moghaddam

ROSHAN NAIR Roshan.dasnair@nottingham.ac.uk
Professor of Clinical Psychology and Neuropsychology



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

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