Comparing the effectiveness of behavioral activation in group vs. self-help format for reducing depression, repetitive thoughts, and enhancing performance of patients with major depressive disorder: a randomized clinical trial

BMC Psychiatry. 2024 Jul 19;24(1):516. doi: 10.1186/s12888-024-05973-z.

Abstract

Background: Behavioral activation has gained increasing attention as an effective treatment for depression. However, the effectiveness of Behavioral Activation Group Therapy (BAGT) in controlled conditions compared to its self-help programs requires more investigation. The present study aimed to compare their effectiveness on depressive symptoms, repetitive negative thinking (RNT), and performance in patients with major depressive disorder (MDD).

Methods: In this randomized clinical trial, 40 patients diagnosed with Major Depressive Disorder (MDD) were recruited based on a structured clinical interview for DSM-5 (SCID-5). Participants were allocated to BAGT (n = 20) and self-help behavioral activation (SBA; n = 20) groups. BAGT received ten weekly sessions (90 min), while the SBA group followed the same protocol as the self-help intervention. Participants were evaluated at pre-treatment, post-treatment, and the 2-month follow-up using the Beck Depression Inventory-II (BDI-II), repetitive thinking questionnaire (RTQ-31), and work and social adjustment scale (WSAS).

Results: The results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, work, and social functioning post-treatment and at the 2-month follow-up. However, the SBA group did not show significant changes in any outcome. The study also found that, based on clinical significance, 68% of the BAGT participants were responsive to treatment, and 31% achieved a high final performance status at the 2-month follow-up.

Discussion: BAGT was more effective than SBA in MDD patients. Participants' engagement with self-help treatment is discussed.

Trial registration: The present trial has been registered in the Iranian Registry of Clinical Trials Center (IRCT ID: IRCT20181128041782N1|| http://www.irct.ir/ ) (Registration Date: 04/03/2019).

Keywords: Behavioral activation group therapy; Depression; Rumination; Social and academic function; Students.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Behavior Therapy / methods
  • Female
  • Humans
  • Major Depressive Disorder* / psychology
  • Major Depressive Disorder* / therapy
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Psychotherapy, Group* / methods
  • Rumination, Cognitive / physiology
  • Self-Help Groups
  • Treatment Outcome
  • Young Adult

Associated data

  • IRCT/IRCT20181128041782N1