The efficacy of acceptance and commitment therapy (ACT) for depression: A systematic review and meta-analysis

Depression is a pervasive global mental health issue and a leading contributor to elevated suicide rates worldwide. Despite the growing body of research, there is currently a lack of studies synthesizing evidence on the efficacy of acceptance and commitment therapy (ACT) specifically for patients diagnosed with depression. Therefore, we conducted this systematic review and meta-analysis to fill in these gaps. A systematic search of ten databases was conducted and ten randomized clinical trials (RCTs) were included. The findings showed ACT had a significant effect on depressive symptoms (SMD=-0.69, 95% CI: -1.06 to -0.32, P<0.001, Certainty: Low) and anxiety symptoms (SMD=-0.64, 95% CI: -0.92 to -0.36, P<0.001, Certainty: Moderate) among individuals with depression, while also showing a positive effect on psychological flexibility (SMD=0.35, 95% CI: 0.09 to 0.61, P=0.008, Certainty: High). Further subgroup results showed that group ACT appeared to be more effective than individual ACT: improving depressive symptom significantly better compared to controls. These findings offer an evidence-based, reliable intervention strategy for clinical practice. More rigorous, multicenter and larger-sample size RCTs are warranted to enhance the validity of these findings.