OBJECTIVE To examine if cognitive restructuring (CR), behavioral activation (BA), and cognitive-behavioral therapy (CBT) result in differential effects in the treatment of adult depression. METHOD We extracted randomized controlled trials (RCTs) from a database updated yearly from PubMed, PsycINFO, Embase, and Cochrane Library. Network and pairwise meta-analyses were conducted to investigate the effects of CR, BA, and CBT delivered in a face-to-face individual format, compared with waiting list (WL) and care-as-usual (CAU), on adult depression. The primary outcome was a standardized mean difference (SMD) in posttreatment depression severity. Tolerability of treatments and depression severity at follow-up were also assessed. RESULTS A total of 45 studies with 3,382 participants were included. There was no evidence of a difference in effectiveness between CR, BA, and CBT. All three interventions were superior to CAU; SMD 0.57, 95% confidence interval [CI 0.08-1.07]; 0.52 [0.34-0.71]; 0.44 [0.28-0.60], respectively and WL 1.20 [0.69-1.70]; 1.15 [0.90-1.40]; 1.07 [0.87-1.26]. No difference in tolerability was found (risk ratio [RR] vs. CAU: 1.01 [0.04-22.81], 0.84 [0.63-1.11], and 0.96 [0.76-1.21], respectively). Metaregression and sensitivity analyses did not produce material differences. CONCLUSIONS Results suggest that CR or BA alone and their combination (CBT) may be effective interventions in comparison to WL and CAU in the treatment of adult depression. There was no evidence suggesting differences in effectiveness among the three treatments. More research is needed to derive conclusions about the performance of CR. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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成人抑郁症治疗中的认知重构、行为激活和认知行为疗法：一项网络荟萃分析。

目的 检验认知重构 (CR)、行为激活 (BA) 和认知行为疗法 (CBT) 是否对成人抑郁症的治疗产生不同的影响。方法 我们从 PubMed、PsycINFO、Embase 和 Cochrane 图书馆每年更新的数据库中提取随机对照试验 (RCT)。进行了网络和成对荟萃分析，以调查以面对面个人形式提供的 CR、BA 和 CBT 与等候名单 (WL) 和照常照料 (CAU) 相比对成人抑郁症的影响. 主要结果是治疗后抑郁严重程度的标准化均值差 (SMD)。还评估了治疗的耐受性和随访时的抑郁严重程度。结果 共纳入 45 项研究，共有 3,382 名参与者。没有证据表明 CR、BA 和 CBT 之间的有效性存在差异。所有三种干预措施均优于 CAU；SMD 0.57，95% 置信区间 [CI 0.08-1.07]；0.52 [0.34-0.71]；分别为 0.44 [0.28-0.60] 和 WL 1.20 [0.69-1.70]；1.15 [0.90-1.40]; 1.07 [0.87-1.26]。未发现耐受性差异（风险比 [RR] 与 CAU：分别为 1.01 [0.04-22.81]、0.84 [0.63-1.11] 和 0.96 [0.76-1.21]）。元回归和敏感性分析没有产生实质性差异。结论 结果表明，与 WL 和 CAU 相比，单独的 CR 或 BA 及其组合 (CBT) 可能是治疗成人抑郁症的有效干预措施。没有证据表明三种治疗方法的有效性存在差异。需要更多的研究来得出关于 CR 性能的结论。