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
Department of Clinical Psychology, Behavioural Science Institute, Radboud University, The Netherlands; and Depression Expertise Center, Pro Persona Mental Health Care, The Netherlands
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
Lorenzo Lorenzo-Luaces
Department of Psychological and Brain Sciences, Indiana University Bloomington, USA
Steven D. Hollon
Department of Psychology, Vanderbilt University, USA
David A. Richards
Department of Health and Community Science, Faculty of Health and Life Sciences, University of Exeter, UK; and Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Norway
Keith S. Dobson
Department of Psychology, University of Calgary, Canada
Sona Dimidjian
Crown Institute and Department of Psychology and Neuroscience, University of Colorado Boulder, USA
Jaime Delgadillo
Clinical and Applied Psychology Unit, University of Sheffield, UK
Fernando L. Vázquez
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain
Kathleen McNamara
Private Practice, Colorado, USA
John J. Horan
Counseling Psychology Program, Arizona State University, USA
Pauline Gardner
Caulfield Pain Management and Research Centre, Caulfield Hospital, Australia
Tian P. Oei
School of Psychology, The University of Queensland, Australia
Anuj H. P. Mehta
Department of Psychology, University of Toronto Scarborough, Canada
Jos W. R. Twisk
Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, The Netherlands
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.
