Trial-Based Cognitive Therapy for depressive and anxious symptoms: A systematic review and meta-analysis of efficacy and dropout rates.

BACKGROUND

With depression and anxiety disorders increasing globally, effective therapies like Trial-Based Cognitive Therapy (TBCT), a novel Cognitive-Behavioral Therapy (CBT) variant, are crucial. This systematic review and meta-analysis aim to assess TBCT's efficacy in reducing depression and anxiety symptoms and its dropout rates compared with other psychotherapies.

METHODS

Comprehensive searches across databases like CENTRAL, PUBMED/MEDLINE, PsycINFO, LILACS/BVS, Clinicaltrials.gov, WHO International Clinical Trials Registry Platform, and Google Scholar were conducted. Eligibility was determined based on the trial's ability to potentially benefit from TBCT and measures of depression or anxiety symptoms using validated scales. Ten RCTs involving 1245 participants were included. The meta-analysis considered post-treatment assessments, dropout rates, and risk of bias. This study was registered on PROSPERO (CRD42021252907).

RESULTS

We identified 10 RCTs involving 1245 participants with various conditions, including Social Anxiety Disorder, Major Depressive Disorder, Post-Traumatic Stress Disorder, and Obsessive-Compulsive Disorder. The meta-analysis of 5 RCTs found no significant difference in symptom reduction between TBCT and other first-choice psychotherapies. TBCT's dropout rates were comparable to other psychotherapies. The majority of RCTs had a low risk of bias.

CONCLUSIONS

TBCT shows comparable efficacy to other psychotherapies in both short-term symptom reduction and long-term treatment gains across various mental health conditions. Its flexibility across different settings and conditions supports its utility in diverse therapeutic contexts. Despite these promising results, more rigorous and geographically diverse studies are necessary to confirm these findings. TBCT offers a promising alternative approach in the psychotherapeutic intervention landscape for mental health disorders.