Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Wong KH (1), Leung SF (2), Ma CF (2)
Affiliation :
(1) Psychiatric Intensive Care Unit, Kwai Chung Hospital, (2) School of Nursing, The Hong Kong Polytechnic University
Introduction :
Behavioral activation is a psychosocial intervention to improve depression by enhancing patients’ participation in everyday activities to achieve their core values. As one of the elements of cognitive behavior therapy, behavioral activation has been proven effective as a stand-alone treatment in various settings and formats. Its short treatment duration is desirable for inpatients requiring short hospitalization. However, there is no existing systematic review and meta-analysis to evaluate the effectiveness of behavioral activation for acute inpatients with depression.
Objectives :
This study aimed to systematically evaluate the evidence on the effectiveness of behavioral activation to improve depression in acute psychiatric settings. The influence of the intervention’s design and the participants’ characteristics on its effectiveness were also discussed.
Methodology :
This review was prepared in line with the PRISMA 2020 statement. The PROSPERO registration was completed in December 2023 (CRD42023489627). Six databases including CINAHL Complete, PsycINFO, Cochrane Library, Embase, Scopus, and PubMed were searched. Only randomized controlled trials published from 1970 to 2023 were selected. Meta-analysis was conducted using the random effects model to pool the intervention effect of behavioral activation on depressive symptoms. Narrative synthesis was conducted to identify the characteristics of the study participants and interventions.
Result & Outcome :
A total of 1281 studies were identified and screened. Three randomized controlled trials met the eligibility criteria with 95 samples were included. All studies had a low risk of bias and demonstrated a statistically significant effect (medium to large) of the intervention on middle-aged and elderly patients with mild to severe depression. All trials adopted Lejuze’s BATD manual to deliver the intervention. Meta-analysis revealed that the intervention significantly reduced depressive symptoms (g = -0.49, 95% CI = -0.90 to -0.07, p = 0.02). The studies showed that clinicians with CBT training, psychologists or psychiatric nurses were able to provide effective behavioral activation to patients with depression.
Behavioral activation intervention has promising effectiveness for patients who are experiencing acute depressive conditions. The major limitation of this study was limited eligible trials. Further intervention studies are recommended in acute psychiatric settings adopting Lejuze’s manual to deliver behavioral activation in a group-based face-to-face format in two weeks for ten sessions.
