Background Behavioural and cognitive interventions remain credible approaches in addressing loneliness and depression. There was a need to rapidly generate and assimilate trial-based data during COVID-19. Objectives We undertook a parallel pilot RCT of behavioural activation (a brief behavioural intervention) for depression and loneliness (Behavioural Activation in Social Isolation, the BASIL-C19 trial [ISRCTN94091479][1]). We also assimilate these data in a living systematic review (PROSPERO CRD42021298788) of cognitive and/or behavioural interventions. Methods Participants (≥65 years) with long-term conditions were computer randomised to behavioural activation (n=47) versus care as usual (n=49). Primary outcome was PHQ-9. Secondary outcomes included loneliness (De Jong Scale). Data from the BASIL-C19 trial were included in a metanalysis of depression and loneliness. Findings The 12 months adjusted mean difference for PHQ-9 was −0.70 (95% CI −2.61 to 1.20) and for loneliness was −0.39 (95% CI −1.43 to 0.65). The BASIL-C19 living systematic review (12 trials) found short-term reductions in depression (standardised mean difference (SMD)=−0.31, 95% CI −0.51 to −0.11) and loneliness (SMD=−0.48, 95% CI −0.70 to −0.27). There were few long-term trials, but there was evidence of some benefit (loneliness SMD=−0.20, 95% CI −0.40 to −0.01; depression SMD=−0.20, 95% CI −0.47 to 0.07). Discussion We delivered a pilot trial of a behavioural intervention targeting loneliness and depression; achieving long-term follow-up. Living meta-analysis provides strong evidence of short-term benefit for loneliness and depression for cognitive and/or behavioural approaches. A fully powered BASIL trial is underway. Clinical implications Scalable behavioural and cognitive approaches should be considered as population-level strategies for depression and loneliness on the basis of a living systematic review. Data are available on reasonable request. The BASIL research collective is especially keen that the BASIL data contributes to prospective meta-analyses and individual patient data meta-analyses. Requests for data sharing will be considered by the independent trial steering and data monitoring committee. Full underlying (non-aggregated) data cannot be made publicly available since the ethics approval of this study does not cover openly publishing non-aggregated data. [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN94091479

中文翻译：

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我们可以通过行为激活来减轻社会孤立的心理影响吗？英国BASIL紧急公共卫生COVID-19试点随机对照试验和活体系统评价的长期结果

背景 行为和认知干预仍然是解决孤独和抑郁问题的可靠方法。在 COVID-19 期间，需要快速生成和吸收基于试验的数据。目标 我们针对抑郁和孤独进行了一项行为激活（简短的行为干预）的平行试点随机对照试验（社交隔离中的行为激活，BASIL-C19 试验 [ISRCTN94091479][1]）。我们还在认知和/或行为干预的实时系统评价（PROSPERO CRD42021298788）中吸收这些数据。方法 患有长期疾病的参与者（≥65 岁）通过计算机随机分为行为激活组（n=47）和照常护理组（n=49）。主要结果是 PHQ-9。次要结果包括孤独感（德容量表）。BASIL-C19 试验的数据被纳入抑郁和孤独感的荟萃分析中。结果 PHQ-9 的 12 个月调整平均差为 -0.70（95% CI -2.61 至 1.20），孤独感为 -0.39（95% CI -1.43 至 0.65）。BASIL-C19生活系统评价（12项试验）发现抑郁症（标准化平均差（SMD）=-0.31，95% CI -0.51至-0.11）和孤独感（SMD=-0.48，95% CI - 0.70至-0.27)。长期试验很少，但有证据表明有一些益处（孤独感 SMD=-0.20，95% CI -0.40 至 -0.01；抑郁症 SMD=-0.20，95% CI -0.47 至 0.07）。讨论 我们进行了针对孤独和抑郁的行为干预的试点试验；实现长期随访。活体荟萃分析提供了强有力的证据，证明认知和/或行为方法对孤独和抑郁具有短期益处。全面供电的 BASIL 试验正在进行中。临床意义 应将可扩展的行为和认知方法视为基于实时系统评价的人群层面的抑郁和孤独策略。可根据合理要求提供数据。BASIL 研究团体特别热衷于 BASIL 数据有助于前瞻性荟萃分析和个体患者数据荟萃分析。数据共享请求将由独立试验指导和数据监测委员会考虑。完整的基础（非汇总）数据无法公开，因为本研究的伦理批准不包括公开发布非汇总数据。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN94091479