Cognitive–behavioural therapy (CBT) is frequently used as an umbrella term to include a variety of psychological interventions. It remains unclear whether more complex CBT contributes to greater depression reduction.

To (a) compare the effectiveness of core, complex and ultra-complex CBT against other psychological intervention, medication, treatment-as-usual and no treatment in reducing depression at post-treatment and in the long term and (b) explore important factors that could moderate the effectiveness of these interventions.

MEDLINE, PsycInfo, Embase, Web of Science and the Cochrane Register of Controlled Trials were searched to November 2021. Only randomised controlled trials were eligible for the subsequent network meta-analysis.

We included 107 studies based on 15 248 participants. Core (s.m.d. = −1.14, 95% credible interval (CrI) −1.72 to −0.55 [m.d. = −8.44]), complex (s.m.d. = −1.24, 95% CrI −1.85 to −0.64 [m.d. = −9.18]) and ultra-complex CBT (s.m.d. = −1.45, 95% CrI −1.88 to −1.02 [m.d. = −10.73]) were all significant in reducing depression up to 6 months from treatment onset. The significant benefits of the ultra-complex (s.m.d. = −1.09, 95% CrI −1.61 to −0.56 [m.d. = −8.07]) and complex CBT (s.m.d. = −0.73, 95% CrI −1.36 to −0.11 [m.d. = −5.40]) extended beyond 6 months. Ultra-complex CBT was most effective in individuals presenting comorbid mental health problems and when delivered by non-mental health specialists. Ultra-complex and complex CBT were more effective for people younger than 59 years.

For people without comorbid conditions healthcare and policy organisations should invest in core CBT. For people <59 years of age with comorbid conditions investments should focus on ultra-complex and complex CBT delivered without the help of mental health professionals.

认知行为疗法（CBT）经常被用作一个总称，包括各种心理干预。目前尚不清楚更复杂的 CBT 是否有助于更大程度地减少抑郁症。

(a) 比较核心、复杂和超复杂 CBT 与其他心理干预、药物治疗、常规治疗和不治疗在治疗后和长期减少抑郁症的有效性和 (b) 探索重要因素这可能会降低这些干预措施的有效性。

MEDLINE、PsycInfo、Embase、Web of Science 和 Cochrane Register of Controlled Trials 检索到 2021 年 11 月。只有随机对照试验符合随后的网络荟萃分析的条件。

我们纳入了基于 15248 名参与者的 107 项研究。核心（smd = -1.14, 95% 可信区间 (CrI) -1.72 至 -0.55 [md = -8.44]），复合物（smd = -1.24, 95% CrI -1.85 至 -0.64 [md = -9.18]）和超复杂 CBT（smd = -1.45, 95% CrI -1.88 至 -1.02 [md = -10.73]）在治疗开始后长达 6 个月的抑郁症中均显着降低。超复杂 (smd = -1.09, 95% CrI -1.61 至 -0.56 [md = -8.07]) 和复杂 CBT (smd = -0.73, 95% CrI -1.36 至 -0.11 [md = - 5.40]）延长超过 6 个月。超复杂的 CBT 对存在合并心理健康问题的个体以及由非心理健康专家提供时最有效。超复杂和复杂的 CBT 对 59 岁以下的人更有效。

对于没有合并症的人，医疗保健和政策组织应投资于核心 CBT。对于 59 岁以下患有合并症的人，投资应侧重于在没有心理健康专业人员帮助的情况下提供的超复杂和复杂的 CBT。