https://doi.org/10.1177/0269215519896404 Clinical Rehabilitation 1–10 © The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0269215519896404 journals.sagepub.com/home/cre CLINICAL REHABILITATION Behavioural activation treatment for depression in individuals with neurological conditions: a systematic review Lloyd L Oates 1,2 , Nima Moghaddam 1 , Nikos Evangelou 3 and Roshan das Nair 4,5 Abstract Objective: To evaluate the effectiveness of behavioural activation interventions for people with neurological conditions with comorbid depression, and explore content and adaptations. Data sources: PsycINFO, MEDLINE, CINAHL, AMED, and EMBASE databases were searched on the 19 November 2019. Reference lists of selected full-texts were screened by title. Review methods: We included peer-reviewed studies published in English that used behavioural activation for treatment of depression in adults with a neurological condition. Single-case reports, reviews, and grey literature were excluded. Methodological quality was assessed by two authors independently, and quality was appraised using Critical Appraisal Skills Programme checklists. Results: From 2714 citations, 10 articles were included comprising 590 participants. Behavioural activation was used to treat depression in people with dementia (n = 4), stroke (n = 3), epilepsy (n = 1), Parkinson’s disease (n = 1), and brain injury (n = 1). Sample size ranged from 4 to 105 participants. There were seven randomized controlled studies; however, no studies compared behavioural activation to an alternative psychological therapy. The effect sizes varied between small and large in the studies where effect size could be calculated (d = 0.24–1.7). Methodological quality of the included studies was variable. Intervention components were identifying and engaging in pleasurable activities, psychoeducation, and problem-solving. Adaptations included delivering sessions via telephone, delivering interventions via primary caregivers, and giving psychoeducation to caregivers. Conclusion: The effectiveness of behavioural activation in randomized controlled trials varied from small to large (d = 0.24–1.7) in reducing depression. The content of behavioural activation was comparable to established treatment manuals. Adaptations appeared to support individuals to engage in therapy. Review registration: PROSPERO 2018, CRD42018102604. 896404CRE 0 0 10.1177/0269215519896404Clinical RehabilitationOates et al. research-article 2019 Original Article 1 University of Lincoln, Lincoln, UK 2 Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK 3 Division of Neurosciences, University of Nottingham, Nottingham, UK 4 Institute of Mental Health, University of Nottingham, Nottingham, UK 5 Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK Corresponding author: Roshan das Nair, Institute of Mental Health, University of Nottingham, B19, Jubilee Campus, Nottingham NG7 2TU, UK. Email: Roshan.Dasnair@nottingham.ac.uk