Efectividad de la terapia de activación conductual en adultos con sintomatología depresiva: una revisión sistemática
Effectiveness of behavioral activation therapy in adults with depressive symptoms: a systematic reviewBarra lateral del artículo
Contenido principal del artículo
Introducción: La activación conductual es una intervención analítico-funcional orientada a reconfigurar las rutinas del paciente mediante actividades dirigidas a sus valores personales. Objetivo: Analizar la efectividad de la activación conductual en el tratamiento de los síntomas depresivos en adultos. Método: Se realizó una revisión sistemática con síntesis narrativa conforme a estándares internacionales de reporte, en seis bases de datos, identificando 251 registros y seleccionando 18 estudios empíricos publicados entre 2021 y 2026. Resultados: Los hallazgos muestran que, el 65 % de los estudios reportó reducciones significativas con tamaños de efecto moderados a grandes, y el 70 % correspondió a ensayos clínicos aleatorizados. Conclusión: La activación conductual se constituye como una intervención con respaldo empírico para el abordaje de los síntomas depresivos en adultos.
Introduction: Behavioral activation is a functional-analytic intervention aimed at restructuring patients' routines through activities aligned with their personal values. Objective: To analyze the effectiveness of behavioral activation in treating depressive symptoms in adults. Method: A systematic review with narrative synthesis was conducted in accordance with international reporting standards. Six databases were searched, yielding 251 records, of which 18 empirical studies published between 2021 and 2026 were selected. Results: The findings showed that 65% of the studies reported significant reductions in depressive symptoms, with moderate to large effect sizes, and 70% were randomized controlled trials. Conclusion: Behavioral activation is an empirically supported intervention for addressing depressive symptoms in adults.
Descargas
Detalles del artículo
Alber, C. S., Krämer, L. V., Rosar, S. M., & Mueller-Weinitschke, C. (2023). Internet-based behavioral activation for depression: Systematic review and meta-analysis. Journal of Medical Internet Research, 25, Article e41643. https://doi.org/10.2196/41643
Berg, H., Akeman, E., McDermott, T. J., Cosgrove, K. T., Kirlic, N., Clausen, A. N., Cannon, M., Yeh, H.-W., White, E. C., Thompson, W. K., Choquette, E. M., Sturycz-Taylor, C. A., Cochran, G., Ramirez, S., Martell, C. R., Wolitzky-Taylor, K. B., Craske, M. G., Abelson, J. L., Paulus, M. P., & Aupperle, R. L. (2023). A randomized clinical trial of behavioral activation and exposure-based therapy for adults with generalized anxiety disorder. Journal of Mood and Anxiety Disorders, 1, Article 100004. https://doi.org/10.1016/j.xjmad.2023.100004
Blomberg, O., Svedin, F., Farrand, P., Brantnell, A., von Essen, L., Patriksson, J., . . . Woodford, J. (2024). Adaptation of a guided low-intensity behavioral activation intervention for people with dementia in Sweden: A qualitative study exploring the needs and preferences of key stakeholders. BMC Geriatrics, 24(1), Article 100004. https://doi.org/10.1186/s12877-023-04606-6
Byrne, M. K., Easpaig, B. N. G., Gray, R., Creek, R., Jones, M., Brown, E., Mitchell, D., Zhai, J., Tan, J.-Y., Denis, S., & Bressington, D. (2023). Behavioural activation for depressive symptoms in young people with emerging or early psychosis: A pilot study protocol. PLOS ONE, 18(1), Article e0280559. https://doi.org/10.1371/journal.pone.0280559
Cernasov, P. M., Walsh, E. C., Nagy, G. A., Kinard, J. L., Kelley, L., Phillips, R. D., Pisoni, A., Diehl, J., Haworth, K., West, J., Freeman, L., Pfister, C., Scott, M., Daughters, S. B., Gaylord, S., Dichter, G. S., & Smoski, M. J. (2024). A parallel-arm, randomized trial of behavioral activation therapy for anhedonia versus mindfulness-based cognitive therapy for adults with anhedonia. Behaviour Research and Therapy, 182, Article 104620. https://doi.org/10.1016/j.brat.2024.104620
Cuijpers, P., Karyotaki, E., Harrer, M., & Stikkelbroek, Y. (2023). Individual behavioral activation in the treatment of depression: A meta analysis. Psychotherapy Research, 33(7), 886–897. https://doi.org/10.1080/10503307.2023.2197630
Dahne, J., Wahlquist, A. E., Carpenter, M. J., Graboyes, E. M., Lejuez, C. W., Kustanowitz, J., Natale, N., Levins, O., Player, M., & Diaz, V. A. (2025). A digital depression treatment program for adults treated in primary care: A randomized clinical trial. JAMA Internal Medicine, 185(6), 692–701. https://doi.org/10.1001/jamainternmed.2025.0494
Ekers, D., Webster, L., van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014). Behavioural activation for depression: An update of meta-analysis of effectiveness and sub group analysis. PLOS ONE, 9(6), Article e100100. https://doi.org/10.1371/journal.pone.0100100
Errazuriz, A., Avello-Vega, D., Ramirez-Mahaluf, J. P., Torres, R., Crossley, N. A., Undurraga, E. A., & Jones, P. B. (2023). Prevalence of depressive disorder in the adult population of Latin America: A systematic review and meta-analysis. The Lancet Regional Health – Americas, 26, Article 100587. https://doi.org/10.1016/j.lana.2023.100587
Fernández-Rodríguez, C., Coto-Lesmes, R., Martínez-Loredo, V., González-Fernández, S., & Cuesta, M. (2023). Is activation the active ingredient of transdiagnostic therapies? A randomized clinical trial of behavioral activation, acceptance and commitment therapy, and transdiagnostic cognitive-behavioral therapy for emotional disorders. Behavior Modification, 47(1), 3–45. https://doi.org/10.1177/01454455221083309
Furukawa, T. A., Tajika, A., Toyomoto, R., Sakata, M., Luo, Y., Horikoshi, M., Akechi, T., Kawakami, N., Nakayama, T., Kondo, N., Fukuma, S., Kessler, R. C., Christensen, H., Whitton, A., Nahum-Shani, I., Lutz, W., Cuijpers, P., Wason, J. M. S., & Noma, H. (2025). Cognitive behavioral therapy skills via a smartphone app for subthreshold depression among adults in the community: The RESiLIENT randomized controlled trial. Nature Medicine, 31(6), 1830–1839. https://doi.org/10.1038/s41591-025-03639-1
Garcés Rojas, D. A., Bianchi, J. M., & Arellanez Hernández, J. L. (2025). Activación conductual para la depresión y el uso nocivo de alcohol en mexicanos. Acta Comportamentalia, 33(1), 71–98. https://doi.org/10.32870/ac.v33i1.88528
Gordillo-Covaleda, A. F., García-Neme, D., & Bianchi, J. M. (2025). Activación conductual grupal: Adaptación del BATD a cinco sesiones y efecto transdiagnóstico. Acta Comportamentalia, 33(2), 275–302. https://doi.org/10.32870/ac.v33i1.88584
Haakana, R., Rosenström, T., Parkkinen, L., Tuomisto, M. T., & Isometsä, E. (2024). Effectiveness of an add-on brief group behavioral activation treatment for depression in psychiatric care: A randomized clinical trial. Frontiers in Psychiatry, 15, Article 1284363. https://doi.org/10.3389/fpsyt.2024.1284363
Heise, M., Bruijniks, S. J. E., Holmes, E. A., & Renner, F. (2026). Effects of an imagery-enhanced behavioral activation intervention on depressive symptoms and activation levels: Results from the WIMBA-trial. Journal of Affective Disorders, 407, Article 121794. https://doi.org/10.1016/j.jad.2026.121794
Hernández-Mariño, E., Bianchi Salguero, J. M., & Toro, R. (2024). Efecto del tratamiento grupal breve de activación conductual para depresión (BATD-G) en personas privadas de la libertad. Acta Colombiana de Psicología, 27(1), 115–136. https://doi.org/10.14718/ACP.2024.27.1.6
Jia, E., Macon, J., Doering, M., & Abraham, J. (2025). Effectiveness of digital behavioral activation interventions for depression and anxiety: Systematic review and meta-analysis. Journal of Medical Internet Research, 27, Article e68054. https://doi.org/10.2196/68054
Kennedy, M. A., Stevens, C. J., Pepin, R., & Lyons, K. D. (2024). Behavioral activation: Values-aligned activity engagement as a transdiagnostic intervention for common geriatric conditions. The Gerontologist, 64(4), Article gnad046. https://doi.org/10.1093/geront/gnad046
Kohn, R., Ali, A. A., Puac-Polanco, V., Figueroa, C., López-Soto, V., Morgan, K., Saldivia, S., & Vicente, B. (2018). Mental health in the Americas: An overview of the treatment gap. Revista Panamericana de Salud Pública, 42, Article e165. https://doi.org/10.26633/RPSP.2018.165
Lee, S. W., Seo, H. S., Choi, M., & Lee, S. J. (2025). A randomized controlled trial of group-based acceptance and commitment therapy for major depressive disorder. Psychiatry Investigation, 22(11), 1300–1308. https://doi.org/10.30773/pi.2025.0093
Li, Y., & Tang, C. (2024). A systematic review of the effects of rumination-focused cognitive behavioral therapy in reducing depressive symptoms. Frontiers in Psychology, 15, Article 1447207. https://doi.org/10.3389/fpsyg.2024.1447207
Liu, M., Du, J., Cheng, C., Peng, D., & Mao, Q. (2026). Efficacy and mechanism of activity scheduling with positive imagery for behavioural activation in subclinical depression: A randomized controlled trial. Psychology and Psychotherapy: Theory, Research and Practice, 99(2), 519–542. https://doi.org/10.1111/papt.70041
Malik, K., Ibrahim, M., Bernstein, A., Venkatesh, R. K., Rai, T., Chorpita, B., & Patel, V. (2021). Behavioral activation as an ‘active ingredient’ of interventions addressing depression and anxiety among young people: A systematic review and evidence synthesis. BMC Psychology, 9, Article 150. https://doi.org/10.1186/s40359-021-00655-x
Medina-Jiménez, E. A., Acosta-Quiroz, C. O., García-Flores, R., Aguilar-Navarro, S. G., & Sotelo-Ojeda, J. E. (2024). Behavioral activation therapy for depression led by health personnel in older people: A scoping review. Gerontology and Geriatric Medicine, 10. https://doi.org/10.1177/23337214241300652
Morocho Castro, C. N., & Santos Pazos, D. A. (2025). Efectividad de la terapia cognitivo conductual en pacientes con depresión. Polo del Conocimiento, 10(7), 258–279. https://polodelconocimiento.com/ojs/index.php/es/article/view/9888
Pepinosa Andrade, L. A., Andrade Castillo, G. E., & Oñate Porras, J. F. (2024). Activación conductual para reducir sintomatología depresiva, caso único. Análisis y Modificación de Conducta, 50(184), 51–65. https://doi.org/10.33776/amc.v50i184.8061
Potsch, L., & Rief, W. (2024). Effectiveness of behavioral activation and mindfulness in increasing reward sensitivity and reducing depressive symptoms: A randomized controlled trial. Behaviour Research and Therapy, 173, Article 104455. https://doi.org/10.1016/j.brat.2023.104455
Pott, S. L., Kellett, S., Green, S., Daughters, S., & Delgadillo, J. (2022). Behavioral activation for depression delivered by drug and alcohol treatment workers: A pilot randomized controlled trial. Journal of Substance Abuse Treatment, 139, Article 108769. https://doi.org/10.1016/j.jsat.2022.108769
Saberi, S., Ahmadi, R., Khakpoor, S., Pirzeh, R., Hasani, M., Moradveisi, L., & Saed, O. (2024). 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, 24, Article 516. https://doi.org/10.1186/s12888-024-05973-z
Sardashti, S., Farhadian, M., Ghaleiha, A., Renner, F., Ahsani-Nasab, S., & Moradveisi, L. (2025). An online group behavioral activation therapy for major depressive disorder: Adaptation, effectiveness, and trajectories of change in a lower-middle income country. Journal of Behavior Therapy and Experimental Psychiatry, 87, 102013. https://doi.org/10.1016/j.jbtep.2024.102013
So, Y., Shin, J., Won, S.-D., Im, W., Seok, K.-H., Jin, M. J., Lee, S. H., & Bae, S.-M. (2025). Validation of the effectiveness of a behavioral activation-based digital app for treatment of depressive symptoms: A randomized controlled trial. Behavioral Sciences, 15(11), Article 1496. https://doi.org/10.3390/bs15111496
Tindall, L., Kerrigan, P., Li, J., Hayward, E., & Gega, L. (2024). Is behavioural activation an effective treatment for depression in children and adolescents? An updated systematic review and meta-analysis. European Child & Adolescent Psychiatry, 33(12), 4133–4156. https://doi.org/10.1007/s00787-024-02429-
Uphoff, E., Pires, M., Barbui, C., Barua, D., Churchill, R., Cristofalo, D., Ekers, D., Fottrell, E., Mazumdar, P., Purgato, M., Rana, R., Wright, J., & Siddiqi, N. (2020). Behavioural activation therapy for depression in adults with non-communicable diseases. Cochrane Database of Systematic Reviews, 2020(8), Article CD013461. https://doi.org/10.1002/14651858.CD013461.pub2
Wang, X., & Feng, Z. (2022). A narrative review of empirical literature of behavioral activation treatment for depression. Frontiers in Psychiatry, 13, Article 845138. https://doi.org/10.3389/fpsyt.2022.845138
Yisma, E., Muyambi, K., Walsh, S., Othman, S., Gray, R., Tan, K. L., Steen, M., & Jones, M. (2025). Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: Systematic review and meta-analysis. BJPsych Open, 11(2), Article e70. https://doi.org/10.1192/bjo.2024.870
Zainab, R., Kandasamy, A., Bhat, N. A., Dsouza, C. V., Jennings, H., Jackson, C., Mazumdar, P., Hewitt, C. E., Ekers, D., Narayanan, G., Rao, G. N., Coales, K., Muliyala, K. P., Chaturvedi, S. K., Murthy, P., & Siddiqi, N. (2023). Behavioral activation for comorbid depression in people with noncommunicable disease in India: Protocol for a randomized controlled feasibility trial. JMIR Research Protocols, 12, Article e41127. https://doi.org/10.2196/41127
Zhang, Y., Jia, X., Yang, Y., Sun, N., Shi, S., & Wang, W. (2024). Change in the global burden of depression from 1990–2019 and its prediction for 2030. Journal of Psychiatric Research, 178, 16–22. https://doi.org/10.1016/j.jpsychires.2024.07.054
Zhao, L., Lou, Y., Tao, Y., Wang, H., & Xu, N. (2025). Global, regional and national burden of depressive disorders in adolescents and young adults, 1990–2021: Systematic analysis of the Global Burden of Disease Study 2021. Frontiers in Public Health, 13, Article 1599602. https://doi.org/10.3389/fpubh.2025.1599602