A Cochrane review [Abstract] 1 included 25 studies with a total of 955 subjects. All forms and severities of depression were represented in the trials, the patients were predominantly women. The categories of behavioural therapies (BT) in the included studies were as follows: behavioural therapy (11 studies), behavioural activation (one study), social skills training model (SST)/assertion (8 studies), other behavioural therapies (2 studies) and both behavioural therapy and SST/assertion (one study). Trials compared behavioural therapies with one or more of 5 other major categories of psychological therapies: cognitive-behavioural, third wave cognitive-behavioural, psychodynamic, humanistic and integrative. In 10 out of 25 studies included the participants received group therapy, and in 12 out of 25 studies they received individual therapy. The duration of intervention ranged from 3.5 to 16 weeks. Compared with all other psychological therapies together, behavioural therapies showed no significant difference in response rate (RR 0.97, 95% CI 0.86 to 1.09; 18 studies, n=690) or in acceptability (RR of total dropout rate 1.02, 95% CI 0.65 to 1.61; 15 studies, n=495). In comparison with each of the other classes of psychological therapies, there was better response to cognitive-behavioural than to behavioural therapies (RR 0.93, 95% CI 0.83 to 1.05; 15 studies, n=544) and better response to behavioural over psychodynamic therapies (RR 1.24, 95% CI 0.84 to 1.82; 2 studies, n=110). When compared with integrative and humanistic therapies, only one study was included in each comparison, and the analysis showed no significant difference between behavioural and integrative or humanistic therapies.
Comment: The quality of the evidence is downgraded by study quality (unclear allocation concealment), inconsistency (heterogeneity in patients and interventions), imprecise results (small trials) and indirectness of evidence (short follow-up time).
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