The Effects of Cognitive Behavioral Therapy Interventions on Emotional Disorders in Iranian Studies: A Systematic Review and Meta-Analysis

Leila Mirzaei; Zahra Golizade; Abolfazl Farid

doi:10.18502/ijps.v21i1.20568

. 2026 Jan;21(1):97–117. doi: 10.18502/ijps.v21i1.20568

The Effects of Cognitive Behavioral Therapy Interventions on Emotional Disorders in Iranian Studies: A Systematic Review and Meta-Analysis

Leila Mirzaei ¹, Zahra Golizade ², Abolfazl Farid ^2,^*

PMCID: PMC13111963 PMID: 42051273

Abstract

Objective: This study systematically integrates and reviews the results of Iranian studies on the effectiveness of cognitive behavioral therapy (CBT) for emotional disorders.

Method : To ensure a comprehensive review, relevant Iranian studies from 2001 to 2024 were identified from databases such as Google Scholar, Web of Science, Scopus, PubMed, SID, Noormags, and MagIran using keywords including CBT, emotional disorders, anxiety, depression, OCD, PTSD, and stress.

Results: Based on the inclusion criteria, 93 effect sizes from 65 Iran-based studies were selected for analysis. The random-effects model revealed a significant overall effect size of CBT on emotional disorders, with g = 1.07, p < 0.001, and a 95% confidence interval ranging from 0.95 to 1.20. The primary analysis indicated that CBT effectively improved various emotional disorders, including anxiety (g = 1.04), depression (g = 1.09), OCD (g = 1.19), PTSD (g = 0.39), and stress (g = 1.27). Subgroup analysis showed no significant gender differences in the effectiveness of CBT, whereas meta-regression revealed a significant association between the effect size of CBT and the age of Iranian participants.

Conclusion: The CBT intervention method has been an effective treatment for emotional disorders and has significantly improved anxiety, depression, OCD, and PTSD in Iranian populations; however, its effect on stress was not statistically significant in this study.

Key Words: Cognitive Behavioral Therapy, Emotional Disorders, Evidence-Based Interventions, Meta-Analysis, Psychological Disorders, Systematic Review

Emotional disorders encompass mood and anxiety disorders such as major depressive disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD), as classified in the DSM-5 (1). These disorders are often associated with emotional dysregulation, which involves difficulties in modulating negative emotions (such as sadness, anxiety, and fear), coupled with maladaptive patterns like pervasive avoidance, rumination, and heightened physiological reactivity (2). They are highly prevalent and recurrent, contributing substantially to disability and socioeconomic costs (3). In 2019, approximately 4.05% of the global population, about 301 million people, were affected by anxiety disorders, representing an increase of over 55% compared to 1990 (4). Most researchers agree that the spectrum of emotional disorders includes unipolar mood and anxiety disorders, encompassing social anxiety disorder, PTSD, OCD, panic disorder, and GAD (1).

Stress- and anxiety-related disorders are among the most common and costly mental health conditions (5). GAD is characterized by excessive, persistent, and unrealistic worry about everyday matters. This worry may be multifaceted, including financial, family, health, and future concerns. It is excessive, difficult to control, and is often accompanied by various nonspecific psychological and physical symptoms. Excessive worry is the central feature of generalized anxiety disorder (6) and causes significant impairment during childhood, adolescence, and adulthood (7, 8). Individuals with anxiety disorders often experience fear, intense anxiety, and behavioral disturbances, frequently accompanied by muscle tension and ringing in the ears as responses to perceived threats or avoidance behaviors. Depressive disorders involve mood regulation difficulties characterized by episodes of depression, irritability, and mania (1). Chronic mental disorders reduce quality of life and impair social, occupational, and academic functioning, necessitating simultaneous attention to symptom reduction and functional improvement (9). Notably, the high comorbidity rate of anxiety and depressive disorders, reported to be as high as 80%, underscores the necessity for comprehensive therapeutic approaches (10).

Cognitive behavioral therapy (CBT) is considered the gold standard for treating anxiety disorders, and it is widely regarded as a first-line, evidence-based treatment for mental health conditions, particularly emotional disorders such as anxiety and depression (11). This structured approach focuses on identifying and modifying maladaptive cognitive and behavioral patterns by addressing negative beliefs and dysfunctional behaviors. Through training in emotion regulation and stress management skills, CBT enhances patients’ psychological functioning and overall quality of life (12). In CBT-based psychotherapy, patients are guided to recognize distorted thinking patterns and ineffective behaviors. Cognitive techniques focus on beliefs and thought processes, and behavioral techniques concentrate on actions and behaviors that interact with mental processes (13). Studies have investigated factors predicting response to CBT to optimize treatment personalization and enhance its efficacy (12). The effectiveness of this therapeutic approach has been widely confirmed through extensive research (14). Studies have demonstrated that psychotherapy, particularly CBT, is an effective treatment for emotional disorders in primary care settings (15). A meta-analysis by Li et al. (16) confirmed the effectiveness of CBT in reducing depression, anxiety, and stress in pregnant women. Furthermore, a meta-analysis by Van Loenen et al. (17) demonstrated that virtual reality exposure-based CBT is effective in treating severe anxiety disorders, OCD, and PTSD. A systematic review by Öst et al. (18) also reported the positive impact of CBT in treating PTSD in adults, with effects lasting up to six months after treatment. In Iran, studies have confirmed the effectiveness of CBT in treating emotional disorders. A meta-analysis on Iranian patients with chronic disorders showed that CBT had a significant effect in reducing symptoms of depression and anxiety (19). Additionally, Akbari and Hosseini (20), in a meta-analysis of third-wave behavioral therapies conducted between 2001 and 2017, reported that metacognitive therapies were effective in reducing depressive symptoms.

Despite extensive evidence supporting the effectiveness of CBT, research findings remain scattered and at times contradictory. Such inconsistencies are often attributable to differences in sample characteristics, research methodologies, and assessment tools. For example, while most studies have reported significant benefits of CBT in treating anxiety and depressive disorders, some have found varying effectiveness depending on the type of disorder or the therapeutic modality applied (17, 21, 22). Given these gaps in the literature, and considering the growing application of third-wave CBT approaches and the increasing body of related research in Iran, as well as the fact that most previous meta-analyses have focused solely on single disorders or short-term studies, a comprehensive meta-analysis is warranted. The present study aims to systematically review evidence from 2001 to 2024 regarding the effectiveness of CBT for the most common emotional disorders (anxiety, stress, PTSD, depression, and OCD) in the Iranian population. In addition, it analyzes treatment outcomes by disorder type and examines gender as a moderating variable, with the ultimate goal of informing the development of more precise and effective clinical interventions in Iran.

Materials and Methods

The present study is a systematic review and meta-analysis of Iranian studies that investigated the effectiveness of CBT for emotional disorders. In this study, the PRISMA (23) checklist was used as the preferred guideline for reporting systematic reviews and meta-analyses.

Search Strategy

All available articles in international databases (Google Scholar, PubMed, Web of Science (ISI), and Scopus) and national databases (SID, Noormags, and MagIran) were systematically searched. The search was conducted up to December 2024 and included studies published between 2001 and 2024. Main keywords, based on the independent variable and various dependent outcomes, were: "cognitive-behavioral intervention" OR "CBT" AND "emotional disorders" OR "anxiety" OR "depression" OR "stress" OR "Obsessive-Compulsive Disorder" OR "post-traumatic stress disorder" AND "Iran" OR "Iranian". To ensure comprehensive coverage, search strategies were adapted to each database, and MeSH terms were used where applicable (especially in PubMed). Additionally, reference lists of selected articles were manually reviewed to identify further relevant studies. Duplicates were removed, and the remaining articles were screened for eligibility based on their titles and abstracts.

Inclusion and Exclusion Criteria

Inclusion criteria for the present study were: a. applying quantitative methods to investigate the effectiveness of CBT on emotional disorders in the Iranian population; b. provision of sufficient data to calculate the effect size; c. availability of full text in accessible databases; and d. articles published in Persian and English. e. The articles must include both control and experimental groups, along with pre- and post-intervention assessments. Studies with methodological flaws and without full text were rigorously excluded from the study. Two researchers independently and meticulously reviewed the titles and abstracts of the studies to ensure each met the inclusion criteria. In cases of uncertainty about excluding an article or disagreements in data extraction, the full text was examined, and the opinion of a third researcher was sought. Any remaining disagreements were resolved through discussion and consensus to ensure a thorough and consistent review process.

Data Extraction

A checklist of research project specifications developed by Mesrabadi (24) was used to collect and extract key information from the primary studies. The extracted items included the research title, first author, year of publication, study location, dependent variable(s), type(s) of disorder, participants’ gender, study design, control group condition, assessment tools, effect sizes, validity and reliability of the instruments, target population, sample size, and statistical values or test results required for effect size calculation. All included studies investigated the effectiveness of CBT on emotional disorders.

Quality Assessment

The quality of the studies was independently assessed by two reviewers, with disagreements resolved through consensus or consultation with a third researcher. For randomized controlled trials (RCTs), the Cochrane Risk of Bias tool, version 2 (RoB 2) was applied, evaluating domains such as randomization, allocation concealment, blinding, completeness of outcome data, and selective reporting. Each study was classified as having low risk, some concerns, or high risk of bias (25). Quasi-experimental studies were assessed using the JBI critical appraisal checklist, which considers criteria such as clarity of group definition, adequacy of sample size, control of confounders, validity of instruments, and appropriateness of statistical analysis. Studies were categorized as high, moderate, or low quality according to JBI guidelines (26). The use of these two validated tools according to study design ensured methodological rigor and transparency, while separate reporting of RCTs and quasi-experimental studies enhanced the reproducibility and reliability of the findings.

Statistical Analysis

A random-effects model was used due to expected significant heterogeneity. Hedges’ g index was chosen to calculate effect sizes and correct small sample bias (27). Effect sizes of 0.8, 0.5, and 0.2 were interpreted as large, moderate, and small effects (28). Mean standard error was calculated assuming a normal distribution. Publication bias was assessed using funnel plots and the fail-safe N (FSN) statistic. The Chi-square test (P = 0.01) and I² index were used to determine heterogeneity levels, which were interpreted as low, moderate, and high at 25%, 50%, and 75%, respectively. In this study, the I² value exceeded 75%. Heterogeneity was further analyzed using meta-regression and subgroup analyses. After searching based on inclusion and exclusion criteria, 65 studies were reviewed, and 93 effect sizes were included in the meta-analysis prior to sensitivity analysis. The study selection process is illustrated in Figure 1.

Flow Chart of the Search Phases to Select Studies for Systematic Review Based on the PRISMA Statement

Ethical Consideration

All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Results

Characteristics of Included Studies

According to the inclusion and exclusion criteria, 65 studies were included, yielding 93 effect sizes due to multiple dependent variables. Funnel plot sensitivity analysis identified 20 outliers, leaving 73 effect sizes for final analysis. Of these, 16 were randomized clinical trials (RCTs) and 49 quasi-experimental studies. The studies assessed CBT effects on depression (29), anxiety (27), stress (6), PTSD (3), and OCD (8), with a total of 1,886 participants. Sample sizes in intervention and control groups ranged from 8 to 20. All studies were conducted in Iran between 2001 and 2024 across diverse populations. Regarding gender, 13 studies included only females, 9 only males, and 51 both. Outcome measurement instruments are presented in Table 1. All studies, regardless of design, included a control group with pre- and post-test assessments per eligibility criteria. The main reason most studies were rated as moderate quality was the inability to assign blinding scores due to their interventional nature.

Table 1.

General Characteristics of Studies Included in the Systematic Review

First Author (Year)	N (CBT / Control)	Mean Age or Age Range	Gender	Study Design	Control Group Condition	Assessment Tools	Type of Disorder	Effect Size	Overall Quality
Abdolghaderi, et al. (2014) (29)	10 / 10	18 / 60	Male & Female	Quasi-experimental (pre–post with control group)	No intervention	DASS-21	Anxiety	1.07^*	Moderate
							Depression	0.57^*
							Stress	0.69^*
Akbari, et al. (2009) (30)	10 / 10	20 to 32	Male	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression	Depression	0.60^*	Moderate
Akhundi, et al. (2024) (31)	15 / 15	27	Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Beck Depression Beck Anxiety	Anxiety	0.82^*	Moderate
Akhundi, et al. (2024) (31)	15 / 15	27	Female		No intervention	Beck Depression Beck Anxiety	Depression	1.56^*	Moderate
Alamdarloo, et al. (2019) (32)	12 / 12	Adults	Male	Quasi-experimental (pre–post and follow-up with control group)	No intervention	DASS-21	Anxiety	1.71^*	Moderate
Alamdarloo, et al. (2019) (32)	12 / 12	Adults	Male		No intervention	DASS-21	Stress	2.05 ^■	Moderate
Amir Soleimani and Derakhshani (2024) (33)	15 / 15	9	Male	RCT ( pre–post with control group)	Waitlist	LSAS-SR	Anxiety	14.93 ^■	Some concerns
Arab and Mohammadi (2023) (34)	16 / 16	Aged	Male & Female	Quasi-experimental (pre–post with control group)	No intervention	Death Anxiety Scale (DAS)	Anxiety	1.80^*	Moderate
Baghooli, Kermani, et al. (2020) (35)	25 / 25	55	Male & Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Beck Depression BDI-II	Depression	1.08^*	Moderate
Bahadorzade, et al. (2015) (36)	20 / 20	20 to 40	Male	Quasi-experimental (pre–post with control group)	No intervention	Zung Self-Rating Anxiety Scale (SAS)	Anxiety	1.43^*	Moderate
Bahrami, et al. (2019) (37)	10 / 10	8 to 12	Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	ASEBA	Anxiety	1.09^*	Moderate
Bahrami, et al. (2019) (37)	10 / 10	8 to 12	Female		No intervention	ASEBA	depression	2.18	Moderate
Darvishi, et al. (2021) (38)	12 / 12	50 to 55	Male	Quasi-experimental (pre–post with control group)	Waitlist	Beck Anxiety Beck Depression	Anxiety	1.91^*	Moderate
Darvishi, et al. (2021) (38)	12 / 12	50 to 55	Male	Quasi-experimental (pre–post with control group)	Waitlist	Beck Anxiety Beck Depression	Depression	1.37^*	Moderate
Daryabeigi, et al. (2020) (39)	16 / 16	7 to 10	Male	Quasi-experimental (pre–post with control group)	No intervention	ASEBA / Child Behavior Checklist (CBCL)	Depression	0.78^*	Moderate
Daryabeigi, et al. (2020) (39)	16 / 16	7 to 10	Male	Quasi-experimental (pre–post with control group)	No intervention	ASEBA / Child Behavior Checklist (CBCL)	Depression	0.72^*	Moderate
Daryayelal and Akbari (2022) (40)	10 / 10	18 to 26	Male & Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Social Phobia Inventory – SPIN	Depression	0.72^*	High quality
							PTSD	1.06^*
							Stress	1.45^*
Dehghani (2009) (41)	12 / 12	18 to 50	Female	Quasi-experimental (pre–post with control group)	No intervention	SCL-90-R	Depression	1.05^*	Moderate
Dehshiri (2012) (42)	10 / 10	27	Male & Female	Quasi-experimental (pre–post with control group)	Waitlist	State-Trait Anxiety Inventory (STAI(	Anxiety	2.37 ^■	Moderate
Elahi, et al. (2023) (43)	25 / 25	20 to 50	Male	Quasi-experimental (pre–post with control group)	No intervention	DASS-21	Anxiety	0.84^*	Moderate
							Depression	1.65^*
							Stress	2.25 ^■
Ershadi Manesh (2021) (44)	32 / 27	13	Female	RCT ( pre–post and follow-up with control group)	No intervention	Beck Depression (BDI-II)	Depression	7.6 ^■	Some concerns
Esmaili, et al. (2013) (45)	15 / 15	No reporter	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression (BDI-II)	Depression	1.21^*	Moderate
Gharashi and Moheb (2018) (46)	15 / 15	7 to 11	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	HADS	Depression	1.92^*	Moderate
Gharashi and Moheb (2018) (46)	15 / 15	7 to 11	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	HADS	anxiety	1.23^*	Moderate
Hamedi, et al. (2020) (47)	15 / 15	9 to 15	Male & Female	RCT ( pre–post with control group)	No intervention	State-Trait Anxiety Inventory (STAI) & Children’s Depression Inventory (CDI)	Anxiety	1.35^*	Some concerns
Hamedi, et al. (2020) (47)	15 / 15	9 to 15	Male & Female	RCT ( pre–post with control group)	No intervention		Depression	1.17^*	Some concerns
Hamid, et al. (2011) (48)	15 / 15	Adult	Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression (BDI-II)	Depression	1.91^*	Moderate
Heidarian Fard, et al. (2016) (49)	8 / 8	20 to 29	Female	RCT ( pre–post and follow-up with control group)	No intervention	Social Anxiety Questionnaire (SAQ)	Anxiety	0.31^*	Moderate
Hesar, et al. (2014) (50)	30 / 30	15 to 18	Female	Quasi-experimental (pre–post with control group)	No intervention	DAS-21	Anxiety	0.61^*	Moderate
							Depression	0.08^*
							OCD	0.69^*
Hosseini Nik and Eslamzade (2019) (51)	15 / 15	20 to 40	Female	Quasi-experimental (pre–post with control group)	No intervention	Mississippi PTSD Scale	PTSD	0.32^*	Moderate
Isvand, et al. (2024) (52)	15 / 15	18 to 50	Female	Quasi-experimental (pre–post with control group)	No intervention	Perceived Stress Scale (PSS)	Stress	1.44^*	Moderate
Kamran, et al. (2024) (53)	15 / 15	15	Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Zaleski's Future Anxiety Scal (FAS)	Anxiety	10.46 ^■	High quality
Kamran, et al. (2024) (53)	15 / 15	15	Female		No intervention	Zaleski's Future Anxiety Scal (FAS)	Stress	3.80	High quality
Keyvani and Jahanian (2022) (54)	15 / 15	17 to 22	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Friedman-Test-Anxiety-Questionnaire.	Anxiety	1.69^*	High quality
Keyvani and Jahanian (2022) (54)	15 / 15	17 to 22	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Friedman-Test-Anxiety-Questionnaire.	Anxiety	1.43	High quality
Khaledian, et al. (2014) (55)	12 / 12	Adult	Not reported	RCT ( pre–post with control group)	No intervention	Beck Depression (BDI-II)	Depression	1.53^*	Some concerns
Kochak Ni (2022) (56)	20 / 20	Adult	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Perceived Stress Scale (PSS)	Stress	0.66^*	Moderate
Mami (2015) (57)	8 / 8	18 to 31	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression (BDI-II(	Depression	1.76^*	Moderate
Mehrara, et al. (2018) (58)	15 / 15	9 to 12	Male& Female	RCT ( pre–post with control group)	No intervention	Child State-trait anxiety questionnaire (CSTA)	Anxiety	0.89^*	Some concerns
Mehrara, et al. (2018) (58)	15 / 15	9 to 12	Male& Female	RCT ( pre–post with control group)	No intervention	Child State-trait anxiety questionnaire (CSTA)	Anxiety	0.75^*	Some concerns
Mikaeili Barzili, et al. (2011) (59)	15 / 15	18 to 50	Male & Female	RCT ( pre–post with control group)	No intervention	Yale- Brown Obsessive Compulsive Scale (YBOCS)	OCD	3.02 ^■	Some concerns
Moghtader, et al. (2014) (60)	10 / 10	16 to 40	Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Anxiety Inventory BAI	Anxiety	5.58 ^■	Moderate
Mohammadian Moradkhah, et al. (2022) (61)	12 / 12	Adult	Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression & Yale–Brown Obsessive Compulsive Scale	Depression	0.52^*	Moderate
Mohammadian Moradkhah, et al. (2022) (61)	12 / 12	Adult	Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression & Yale–Brown Obsessive Compulsive Scale	OCD	1.71^*	Moderate
Mohammadnejad, et al. (2022) (62)	12 / 12	20 to 45	Female	Quasi-experimental (pre–post and follow-up with control group)	Waitlist	Yale- Brown Obsessive Compulsive Scale (YBOCS)	OCD	1.58^*	Moderate
Mohammad Zadeh Farhani, et al. (2018) (63)	17 / 17	6 to 12	Male & Female	RCT ( pre–post with control group)	Waitlist	CSI-4	Anxiety	0.33^*	Moderate
Monirpour and Hasani Semnani (2019) (64)	11 / 11	Adult	Female	Quasi-experimental (pre–post and follow-up with control group)	Waitlist	Yale- Brown Obsessive Compulsive Scale (YBOCS)	OCD	1.99^*	Moderate
Narimani (2014) (65)	20 / 20	25	Female	Quasi-experimental (pre–post with control group)	No intervention	Generalized Anxiety Disorder Questionnaire-IV(GAD-Q-IV)	Anxiety	0.73^*	Moderate
Nikmorad, et al. (2013) (66)	15 / 15	Adult	Male	RCT ( pre–post with control group)	No intervention	PCL(Posttraumatic Stress Disorder Checklist)	PTSD	0.09 ^*	Some concerns
Nikneshan, et al. (2020) (67)	8 / 8	5 to 10	Male & Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Parenting Stress Index – Short Form (PSI-SF)	Stress	1.90^*	Moderate
Norozi and Maniea (2017) (68)	20 / 20	18 to 27	Male Female	Quasi-experimental (pre–post with control group)	No intervention	Social Interaction Anxiety Scale (SIAS)	Anxiety	6.80 ^■	Moderate
Nourisaeed, et al. (2022) (69)	15 / 15	30 to 60	Male & Female	RCT ( pre–post with control group)	No intervention	Perceived Stress Questionnaire – PSQ	Stress	1.92^*	Some concerns
Omidi, et al. (2008) (70)	10 / 10	18 to 45	Male & Female	RCT ( pre–post with control group)	No intervention	Structured Clinical Interview for Depression – SCID-I and BSI-53)	OCD	0.60^*	Some concerns
							Anxiety	1.30^*
							Depression	5.05 ^■
Orvati Aziz (2021) (71)	12 / 12	18 to 40	Male & Female	Quasi-experimental (pre–post with control group)	Waitlist	Hamilton Anxiety Rating Scale (HRSA)	Anxiety	2.58 ^■	Moderate
Parvandi, et al. (2022) (72)	18 / 18	8 to 10	Male & Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Separation Anxiety Assessment Scale Parent Version (SAS-P)	Anxiety	1.81^*	Moderate
Pasandian and Hashemi razini (2021) (73)	16 / 16	30	Male & Female	Quasi-experimental (pre–post with control group)	No intervention	Maudsley’s Obsessive-Compulsive Inventory	OCD	1.84^*	Moderate
Pirkalani, et al. (2019) (74)	15 / 15	30 to 50	Female	Quasi-experimental (pre–post with control group)	No intervention	DASS-21	Depression	0.37^*	Moderate
Rajabi, et al. (2018) (75)	10 / 10	13 to 15	Female	Quasi-experimental (pre–post and follow-up with control group)	Introductory session only	Children's Depression Inventory (CDI)	Depression	11.90 ^■	Moderate
Ranjbar, et al. (2010) (76)	16 / 16	Adult	Male& Female	RCT ( pre–post and follow-up with control group)	No intervention	Beck Depression	Depression	0.44^*	Some concerns
Rashed, et al. (2020) (77)	5 / 7	18 to 50	Female	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression	Depression	0.90^*	Moderate
Rezaie, et al. (2013) (78)	14 / 14	20 to 45	Female	RCT ( pre–post with control group)	No intervention	SCL-90-R	Depression	1.72^*	Some concerns
Sadr Mohammadi, et al. (2019) (79)	15 / 15	18 to 55	Male& Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	Beck Depression BDI-II	Depression	0.97^*	Moderate
Saleh, et al. (2015) (80)	15 / 15	12	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Mood and Feelings Questionnaire (MFQ)	Depression	1.78^*	Moderate
Salehi, et al. (2014) (81)	10 / 10	Adult	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Moudzly Obsessive-Compulsive Inventory	OCD	1.30^*	Moderate
Salehi, et al. (2014) (81)	10 / 10	Adult	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Moudzly Obsessive-Compulsive Inventory	OCD	1.16^*	Moderate
Samavatyan, et al. (2021) (82)	8 / 8	7 to 11	Female	Quasi-experimental (pre–post and follow-up with control group)	No intervention	ASEBA	Anxiety	0.28^*	High quality
Samavatyan, et al. (2021) (82)	8 / 8	7 to 11	Female		No intervention	ASEBA	Depression	2.40 ^■	High quality
Sharifi, et al. (2021) (83)	13 / 13	12 to 16	Male & Female	Quasi-experimental (pre–post with control group)	No intervention	Child Abnormal Symptoms Inventory (CSI-4)	Anxiety	6.41^■	Moderate
Shaygan Manesh, et al. (2018) (84)	20 / 20	25	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Social Anxiety Test of SPIN	Anxiety	1.97^*	Moderate
Soleymani, et al. (2015) (85)	14 / 13	18 to 30	Male & Female	RCT ( pre–post with control group)	No intervention	DASS-42	Depression	1.73^*	Some concerns
							Anxiety	4.31 ^■
							Stress	3.53 ^■
Soleimani Sefat, et al. (2017) (86)	15 / 15	15 to 18	Male	Quasi-experimental (pre–post with control group)	No intervention	Beck Depression (BDI-II)	Depression	0.33^*	Moderate
Sotodeh, et al. (2011) (87)	14 / 14	27 to55	Male& Female	RCT ( pre–post with control group)	No intervention	Beck Depression (BDI-II)	Depression	0.44^*	Some concerns
Tajery (2016) (88)	15 / 15	Adult	Male	Quasi-experimental (pre–post and follow-up with control group)	Waitlist	Beck Depression / Beck Anxiety	Depression	1.76^*	Moderate
Tajery (2016) (88)	15 / 15	Adult	Male		Waitlist	Beck Depression / Beck Anxiety	Anxiety	1.03^*	Moderate
Torshizi, et al. (2021) (89)	15 / 15	18 to 40	Female	Quasi-experimental (pre–post with control group)	Waitlist	Yale- Brown Obsessive Compulsive Scale (YBOCS)	OCD	0.66^*	Moderate
Varmzyar, et al. (2021) (90)	15 / 15	36	Male& Female	RCT ( pre–post and follow-up with control group)	Waitlist	Social Phobia Inventory (SPIN)	Anxiety	0.62^*	Some concerns
Yoosefi, et al. (2019) (91)	12 / 12	32	Female	RCT ( pre–post and follow-up with control group)	No intervention	Beck Depression BDI-II	Depression	3.93 ^■	Some concerns
Yoosefi, et al. (2019) (91)	12 / 12	32	Female	RCT ( pre–post and follow-up with control group)	No intervention	Beck Depression BDI-II	Anxiety	1.82^*	Some concerns
Zamani, et al. (2020) (92)	15 / 15	4 to 6	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Spence Children's Anxiety Scale (SCAS)	Anxiety	0.37^*	Moderate
Zamani, et al. (2020) (92)	15 / 15	4 to 6	Male& Female	Quasi-experimental (pre–post with control group)	No intervention	Spence Children's Anxiety Scale (SCAS)	Depression	1.42^*	Moderate
Zargar, et al. (2014) (93)	15 / 15	19 to 30	Male& Female	RCT ( pre–post with control group)	No intervention	SAQ–Najarian & Davoudi	Anxiety	2.27 ^■	Some concerns

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= Significant effect size,

^■

= Outlier effect size, OCD = Obsessive-Compulsive Disorder, PTSD = Post-Traumatic Stress Disorder, RCT = Randomized Controlled Trial, Waitlist = participants were scheduled to receive the CBT intervention after the trial, No intervention = participants did not receive the CBT intervention during the trial.

Figure 2 shows the effect size of CBT on emotional disorders like anxiety, depression, stress, OCD, and PTSD across studies. Each point represents a study’s standardized effect size with a 95% confidence interval. The plot indicates that most studies found a significant positive effect of CBT in reducing symptoms.

Forest Plot of the Effect Size of Cognitive Behavioral Therapy on Emotional Disorder

One of the main assumptions of meta-analysis is the absence of publication bias. In this study, before presenting the results, publication bias was assessed using two methods: funnel plots and the fail-safe N index. In the funnel plots (Figures 3 and 4), the horizontal axis represents effect sizes, and the vertical axis represents standard errors. Asymmetrical dispersion, especially in extreme effect sizes with large errors, indicates publication bias. Figure 4 appears more symmetrical than Figure 3, with effect sizes ranging from –0.5 to 2. According to the fail-safe N index, 3,737 non-significant effect sizes would be required to render the combined effect size non-significant. Finally, by removing 20 extreme effect sizes from the initial 93, a total of 73 effect sizes remained, and analyses were conducted on this refined dataset.

Funnel Plot of Publication Bias Before Sensitivity Analysis Showing Effect Sizes and Standard Errors

Funnel Plot of Publication Bias After Sensitivity Analysis Showing Effect Sizes and Standard Errors

Table 2 shows the effect size of CBT before and after sensitivity analysis. After removing outliers, the effect size slightly decreased but remained significant, indicating the effectiveness of this treatment method.

Table 2.

Fixed and Random Effect Sizes for Cognitive Behavioral Therapy Effectiveness on Emotional Disorders

	Model	No of Effect Sizes	Summary Effect Size	S.E	Z	P
Before sensitivity analysis	Fixed effects	93	1.32	0.04	3.73	0.001
Before sensitivity analysis	Random effects	93	1.64	0.13	12.39	0.001
After sensitivity analysis	Fixed effects	73	1.03	0.04	22.38	0.001
After sensitivity analysis	Random effects	73	1.07	0.06	16.32	0.001

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Table 3 shows the combined effect sizes for anxiety (1.04), depression (1.09), OCD (1.19), PTSD (0.39), and stress (1.27), all statistically significant (P < 0.01) except for stress (P = 0.13). The highest effect size was for OCD and the lowest for PTSD. Heterogeneity was highest for anxiety (I² = 50.99).

Table 3.

The Effectiveness of Cognitive Behavioral Therapy on Anxiety, Depression Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, and Stress

Index	No. of Effect Sizes	Effect Size	SE	Z	P	95% Confidence Interval		Heterogeneity
Index	No. of Effect Sizes	Effect Size	SE	Z	P	Lower	Upper	I ²	P
Anxiety	27	1.04	1.10	9.77	0.001	0.82	1.24	50.99	0.001
Depression	29	1.09	0.11	10.42	0.001	0.93	1.36	46.41	0.001
OCD	8	1.19	0.18	5.87	0.001	0.73	1.47	41.51	0.001
PTSD	3	0.39	0.26	1.49	0.001	0.123	0.9	19.98	0.001
Stress	6	1.27	0.26	5.12	0.1	0.85	1.90	41.83	0.13

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OCD = obsessive-compulsive disorder, PTSD = post-traumatic stress disorder

The gender of participants in the primary studies was categorized into female, male, and mixed groups (Table 4). Effect sizes were 0.80 for females, 0.96 for males, and 1.12 for the mixed group (P = 0.001). Heterogeneity was 59.97 for females, 43.73 for males, and 41.46 for the mixed group, with the highest heterogeneity observed in females.

Table 4.

Effect Sizes of Cognitive Behavioral Therapy on Emotional Disorders by Gender

Gender	No. of Effect Sizes	Effect Size	S.E	95% Confidence Interval		z	P	(I² )
Gender	No. of Effect Sizes	Effect Size	S.E	Lower	upper	z	P	(I² )
Female	13	0.80	0.17	0.53	1.22	4.98	0.001	59.97
Male	9	0.96	0.19	0.6	1.24	5.14	0.001	43.73
Female/Male	51	1.12	0.07	1.01	1.41	15.18	0.001	41.46

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Heterogeneity among effect sizes was assessed using Cochran’s Q (138.84, P < 0.001) and the I² index (48.86%), indicating moderate heterogeneity. Given Cochran’s Q limitations, I² shows that nearly 49% of the variability reflects true heterogeneity. Following Higgins et al. (94), this level is moderate. Heterogeneity will be further examined via subgroups based on the dependent variable and gender. Thus, subsequent analyses use a fixed-effects model with heterogeneity estimates for each subgroup.

Meta-regression analysis was conducted to examine the role of participants' age as a continuous moderator variable. Figure 5 shows the regression line predicting Hedges' g effect size based on the mean age of participants. Both the intercept (0.76) and the regression coefficient (0.01) were statistically significant (P < 0.01). The regression equation (Y = 0.01X + 0.76) indicates a significant positive relationship between participants' age and Hedges' g effect size, meaning that for every one-unit increase in age, the effect size increases by 0.01 units.

Meta-Regression Line Showing the Relationship between Participants’ Age and Hedges' g Effect Size

Discussion

This meta-analysis examined the effectiveness of CBT on emotional disorders, yielding a large effect size of 1.07 based on a random-effects model (28). Results confirmed that CBT is highly effective in treating all emotional disorders, consistent with findings from Li et al. (16), Asadi et al. (95), Van Loenen et al. (17), Kiyanzad et al. (96), and Alipour et al. (97). Specifically, Asadi et al. (95) reported a significant positive effect of CBT on OCD. Additionally, Li et al. (16) demonstrated that CBT interventions effectively improved depression, anxiety, stress, BMI, and quality of life in patients with coronary heart disease.

According to the cognitive-behavioral model, distorted thinking is central to psychological disorders, and modifying such patterns improves mood and behavior, leading to lasting recovery by addressing dysfunctional core beliefs (98). Key cognitive factors in emotional disorders include heightened responsibility, overestimation of risk, thought suppression, and mental inhibition (95). CBT aims to identify and replace irrational, anxiety- and depression-inducing thoughts with rational alternatives. Through this process, individuals gain insight into their thought patterns and actively participate in restructuring them. Behavioral techniques, such as relaxation training, help reduce anxiety and stress by enabling individuals to recognize and manage physical symptoms. Moreover, maladaptive emotion regulation strategies are associated with heightened anxiety and depression. Conversely, adaptive strategies such as planning, acceptance, positive refocusing, and reappraisal enhance social functioning, promote cognitive restructuring, and contribute to improved mental health.

The results of this meta-analysis indicated that despite the large effect size of CBT in treating stress disorders (g = 1.21), the effect was not statistically significant. This can be attributed to several key factors: first, the limited number of studies (six studies) and low statistical power led to small sample sizes, and increased the likelihood of a Type II error (99). Second, the high heterogeneity among studies due to diverse populations (occupational stress, acute stress, chronic stress) and variations in treatment protocols and measurement tools contributed to greater variance and wider confidence intervals, thereby reducing the likelihood of obtaining statistically significant results (100). Third, the clinical complexity of stress disorders, such as chronic stress, requires combined interventions (such as trauma-focused therapies and pharmacotherapy) and longer treatment durations, suggesting that short-term CBT alone may be insufficient to fully alleviate symptoms (15).

A detailed examination of multiple dependent variables showed that CBT has a large effect on depression, OCD, PTSD, and stress, with a large effect size. Originally designed to treat depression, anxiety, phobias, tension, anger, and communication problems, this therapy has consistently demonstrated success. In this approach, the therapist helps clients recognize disruptive behavior as learned and addresses the client’s lack of skills to respond more adaptively (57). Previous research highlights that early treatment engagement is crucial for reducing symptoms of emotional disorders, and achieving the expected outcomes of CBT. Although the effect of CBT in gender subgroups was large according to Cohen’s criteria (28), no significant gender differences were observed. Many recent studies suggest that psychological differences between men and women do not affect CBT effectiveness; instead, differences stem from cultural contexts, early experiences, and training (101).

Based on the findings of the meta-analysis, age was identified as a significant moderator in the effectiveness of CBT. Specifically, regression analysis revealed a significant association between age and therapeutic outcome (Slope = 0.01013, SE = 0.00418, P = 0.015). This suggests that age plays a crucial role in predicting how individuals respond to CBT, underscoring the importance of considering age-related factors in clinical practice and research design. Empirical evidence indicates that changes in cognitive flexibility, executive functioning, and psychological adaptability across the lifespan influence responsiveness to CBT (102). In particular, younger individuals typically demonstrate greater cognitive flexibility and openness to therapeutic interventions, resulting in more favorable treatment outcomes (98). In contrast, older adults may exhibit diminished executive functioning and cognitive rigidity associated with normal aging and chronic comorbid conditions, which may reduce the effectiveness of CBT (103). Meta-analytic studies emphasize that age acts as a significant predictor of treatment response and highlight the need for age-tailored CBT protocols to optimize outcomes (104). The current findings are consistent with this body of evidence, underscoring the vital role of age-related factors in the effectiveness of CBT.

Limitation

The main limitation of this study is the lack of access to all scientific databases for a fully comprehensive search and retrieval of all articles. In addition, due to limited access, this study only reviewed studies conducted in Iran and did not include studies from other countries.

Conclusion

The findings of the systematic review and meta-analysis indicated that CBT produced a large effect size in improving anxiety, depression, obsessive-compulsive disorder, post-traumatic stress disorder, and other stress-related disorders in intervention groups. CBT operates by challenging and replacing negative thoughts, thereby altering individuals’ thought processes, and emphasizes the interconnectedness of thoughts, emotions, and behaviors. Over time, this process of questioning and restructuring negative thoughts can transform cognitive patterns. No significant differences were observed between Iranian men and women in their response to CBT; however, a significant association was found between participants’ age and the effect size of CBT. Therefore, clinicians and researchers are encouraged to consider age-related factors in the design and evaluation of treatments to enhance the generalizability and applicability of CBT across different age groups.

One of the strengths of this study was its comprehensive scope, which enabled the inclusion of all studies related to emotional disorders to be reviewed. The findings may provide valuable implications for therapists regarding the application of CBT treatment in the field of emotional disorders.

Acknowledgment

The authors appreciate all researchers who participated in the preliminary studies.

Funding

The authors did not receive support from any organization for the submitted work.

Authors’ Contributions:

L.M. and Z.G. contributed to the study design and performed the systematic review. A.F. conducted the data analyses. All authors read and approved the final manuscript.

Conflict of Interest

None.

References

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2022. [Google Scholar]
2.Aslan IH, Dorey L, Grant JE, Chamberlain SR. Emotion regulation across psychiatric disorders. CNS Spectr. 2024;29(3):215–20. doi: 10.1017/S1092852924000270. [DOI] [PMC free article] [PubMed] [Google Scholar]
3.Dembek C, Mackie D, Modi K, Zhu Y, Niu X, Grinnell T. The economic and humanistic burden of bipolar disorder in adults in the United States. Ann Gen Psychiatry. 2023;22(1):13. doi: 10.1186/s12991-023-00440-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
4.Javaid SF, Hashim IJ, Hashim MJ, Stip E, Samad MA, Ahbabi AA. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Current Psychiatry. 2023;30(1):44. [Google Scholar]
5.Higgins C, Chambers JA, Major K, Durham RC. Healthcare costs and quality of life associated with the long-term outcome of anxiety disorders. Anxiety Stress Coping. 2021;34(2):228–41. doi: 10.1080/10615806.2020.1839731. [DOI] [PubMed] [Google Scholar]
6.Island T. StatPearls Publishing; 2022 Jan. PMID[Google Scholar]; 2023. [Google Scholar]
7.Essau CA, Lewinsohn PM, Lim JX, Ho MR, Rohde P. Incidence, recurrence and comorbidity of anxiety disorders in four major developmental stages. J Affect Disord. 2018;228:248–53. doi: 10.1016/j.jad.2017.12.014. [DOI] [PMC free article] [PubMed] [Google Scholar]
8.Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, et al. Epidemiology and Impact of Health Care Provider-Diagnosed Anxiety and Depression Among US Children. J Dev Behav Pediatr. 2018;39(5):395–403. doi: 10.1097/DBP.0000000000000571. [DOI] [PMC free article] [PubMed] [Google Scholar]
9.IsHak WW, Mirocha J, Dang J, Vanle B, Metrikin B, Tessema K, et al. Quality of Life and Functioning Impairments Across Psychiatric Disorders in Adults Presenting for Outpatient Psychiatric Evaluation and Treatment. Psychiatr Res Clin Pract. 2024;6(3):68–77. doi: 10.1176/appi.prcp.20230064. [DOI] [PMC free article] [PubMed] [Google Scholar]
10.Groen RN, Ryan O, Wigman JTW, Riese H, Penninx B, Giltay EJ, et al. Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks. BMC Med. 2020;18(1):308. doi: 10.1186/s12916-020-01738-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
11.Mahoney AE, Hobbs MJ, Williams AD, Andrews G, Newby JM. The mediating relationship between maladaptive behaviours, cognitive factors, and generalised anxiety disorder symptoms. Behaviour Change. 2018;35(2):123–38. [Google Scholar]
12.Vieira S, Liang X, Guiomar R, Mechelli A. Can we predict who will benefit from cognitive-behavioural therapy? A systematic review and meta-analysis of machine learning studies. Clin Psychol Rev. 2022;97:102193. doi: 10.1016/j.cpr.2022.102193. [DOI] [PubMed] [Google Scholar]
13.Wallace DD, Carlson RG, Ohrt JH. Culturally adapted cognitive-behavioral therapy in the treatment of panic episodes and depression in an African American woman: a clinical case illustration. J Ment Health Couns. 2021;43(1):40–58. [Google Scholar]
14.Carpenter JK, Andrews LA, Witcraft SM, Powers MB, Smits JAJ, Hofmann SG. Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depress Anxiety. 2018;35(6):502–14. doi: 10.1002/da.22728. [DOI] [PMC free article] [PubMed] [Google Scholar]
15.Cuijpers P, Quero S, Dowrick C, Arroll B. Psychological treatment of depression in primary care: recent developments. Curr Psychiatry Rep. 2019;21(12):129. doi: 10.1007/s11920-019-1117-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
16.Li YN, Buys N, Ferguson S, Li ZJ, Sun J. Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease: A meta-analysis. World J Psychiatry. 2021;11(11):1147–66. doi: 10.5498/wjp.v11.i11.1147. [DOI] [PMC free article] [PubMed] [Google Scholar]
17.van Loenen I, Scholten W, Muntingh A, Smit J, Batelaan N. The Effectiveness of Virtual Reality Exposure-Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder: Meta-analysis. J Med Internet Res. 2022;24(2):e26736. doi: 10.2196/26736. [DOI] [PMC free article] [PubMed] [Google Scholar]
18.Öst LG, Enebrink P, Finnes A, Ghaderi A, Havnen A, Kvale G, et al. Cognitive behavior therapy for adult post-traumatic stress disorder in routine clinical care: A systematic review and meta-analysis. Behav Res Ther. 2023;166:104323. doi: 10.1016/j.brat.2023.104323. [DOI] [PubMed] [Google Scholar]
19.Khanjani M, Pezhman A, Masoudi F, Taherian H. The effectiveness of cognitive behavioral therapy on depression and anxiety in patients with chronic disorders: a systematic review and meta-analysis of clinical trials in Iranian population. Clinical Psychology Achievements. 2025;11(2):13–32. [Google Scholar]
20.Akbari M, Hosseini ZS. A meta-analysis of comparing the efficacy of the third wave of behavior therapies on depression in Iran: Comparing acceptance and commitment therapy, mindfulness-based therapy and metacognitive therapy (2001-2017) Clinical Psychology and Personality. 2020;17(1):175–89. [Google Scholar]
21.Doyle C, Bhar S, Fearn M, Ames D, Osborne D, You E, et al. The impact of telephone‐delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: a randomized controlled trial. Br J Health Psychol. 2017;22(3):542–56. doi: 10.1111/bjhp.12245. [DOI] [PubMed] [Google Scholar]
22.Li X, Laplante DP, Paquin V, Lafortune S, Elgbeili G, King S. Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev. 2022;92:102129. doi: 10.1016/j.cpr.2022.102129. [DOI] [PubMed] [Google Scholar]
23.Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372 doi: 10.1136/bmj.n71. n71. [DOI] [PMC free article] [PubMed] [Google Scholar]
24.Mesrabadi J, Nasrolahi Y. Meta-analysis: concepts, software and reporting. Tabriz: Shahid Madani University Publication; 2016. [Google Scholar]
25.Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. Bmj. 2019;366:l4898. doi: 10.1136/bmj.l4898. [DOI] [PubMed] [Google Scholar]
26.Barker TH, Habibi N, Aromataris E, Stone JC, Leonardi-Bee J, Sears K, et al. The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies. JBI Evid Synth. 2024;22(3):378–88. doi: 10.11124/JBIES-23-00268. [DOI] [PubMed] [Google Scholar]
27.Hedges LV, Pigott TD. The power of statistical tests in meta-analysis. Psychol Methods. 2001;6(3):203–17. [PubMed] [Google Scholar]
28.Cohen J. Statistical power analysis for the behavioral sciences. routledge; 2013. [Google Scholar]
29.Abdolghaderi M, Kafi S-M, Saberi A, Ariaporan S. Effectiveness of mindfulness-based cognitive therapy on hope and pain beliefs of patients with chronic low back pain. Assari S. Social Determinants of Delayed Gratification among American Children. Casp J Neurol Sci. 2020;6(3):181–9. doi: 10.32598/cjns.6.22.2. [DOI] [PubMed] [Google Scholar]
30.Akbari J, Aghamohammadian H, Ghanbari B. Effectiveness of CBT, pharmacotherapy and combined approach in improvement of symptoms depression anger in borderline personality disorder. J Psychol. 2009;13(3):342–59. [Google Scholar]
31.Akhondi YZ, Ghazanfari A, Sharifi T. Comparison of the Effectiveness of Transdiagnostic Treatment and Cognitive-Behavioral Therapy on the Anxiety and Depression of Depressed Women. 2024. [Google Scholar]
32.Alamdarloo GH, Khorasani SM, Najafi M, Jabbari FS, Shojaee S. The effect of cognitive-behavioral therapy on depression, anxiety, and stress levels in Iranian males with addiction. Sage open. 2019;9(1):2158244018824466. [Google Scholar]
33.Amir Soleimani L, Derakhshani F. Academic performance, cognitive behavioral therapy, social anxiety, students. Rooyesh-e-Ravanshenasi Journal (RRJ) 2024 Mar 10;13(1):161–70. [Google Scholar]
34.Arab S, Mohammadi A. The Effectiveness of cognitive-behavioral therapy on sleep disorder and death anxiety in the elderly. Aging Psychology. 2023 May 5;9(1):102–89. [Google Scholar]
35.Baghooli Kermani M, Nikrahan G R, Sadeghi M. The study of the effectiveness of cognitive behavioral therapy on depression and C-reactive protein in cardiac patients. Shenakht Journal of Psychology and Psychiatry. 2020 Sep 10;7(4):1–2. [Google Scholar]
36.Bahadorzade M, Jajarmi M, Jalalabadi M, Eydi-Baygi M. Effectiveness of cognitive-behavioral group therapy on anxiety in addicts with successful cut off. Studies in Medical Sciences. 2015;25(11):961–7. [Google Scholar]
37.Bahrami M, Khayatan F, Farhadi H, Aghaei A. The effectiveness of cognitive-behavioral therapy on children's anxiety in restructured families. Community Health Journal. 2019 Dec 22;13(4):44–53. [Google Scholar]
38.Darvishi M, Zarei E, Hajalizadeh K. Efficiency of Cognitive-Behavioral Therapy on the Depression and Anxiety of the Veterans with Post-Traumatic Stress Disorder. Medical Journal of Mashhad university of Medical Sciences. 2021;64(4):3841–52. [Google Scholar]
39.Daryabeigi M, Pourmohamdreza-Tajrishi M, Dolatshahi B, Bakhshi E. The effectiveness of cognitive-behavioral therapy on internalizing problems of children with externalizing disorders. Iranian Rehabilitation Journal. 2020;18(2):193–202. [Google Scholar]
40.Daryayelal G, Akbari B. The effectiveness of Cognitive behavioral therapy on emotional processing in students with social anxiety disorder. Medical Journal of Mashhad university of Medical Sciences. 2022 Nov 22;65(5) [Google Scholar]
41.Dehghani F, Neshat-Doust H, Molavi H, Nilforoushzadeh M. The effect of cognitive-behavioral stress management therapy on depression and anxiety of females with alopecia Areata. J Clin Psychol (Iran) 2009;1(2):1–9. [Google Scholar]
42.Dehshiri GR. The effectiveness of cognitive-behavior therapy on anxiety and worry of people with generalized anxiety disorder. Journal of clinical psychology. 2012 Jun 21;4(2):19–28. [Google Scholar]
43.Elahi M, Najafi M, Mohammadyfar MA. Comparison of the effectiveness of cognitive-behavioral therapy and metacognitive therapy on psychological distress (stress, anxiety, and depression) in drug addicts. Journal of Modern Psychological Researches. 2023 Sep 23;18(71):13–22. [Google Scholar]
44.Ershadi Manesh S. A controlled comparison of the efficacy of creative problem solving therapy and cognitive behavioural therapy in adolescent'depression. Psychol Sci. 2021;20(100):485–501. [Google Scholar]
45.Asadnia S, Issazadeghan A, Ansari B. Evaluation of the effectiveness of cognitive behavioral therapy on decreasing depression levels and improving the lifestyle of patients with type 2 diabetes. Studies in Medical Sciences. 2013;24(10):812–22. [Google Scholar]
46.Gharashi K, Moheb N. The effect of cognitive-behavioral therapy on reducing the anxiety and depression of children with hearing loss. Auditory and Vestibular Research. 2018;27(1):31–7. [Google Scholar]
47.Hamedi V, Hamid N, Beshlideh K, Marashi SA, Hashemi Sheikh Shabani SE. Effectiveness of conventional cognitive-behavioral therapy and its computerized version on reduction in pain intensity, depression, anger, and anxiety in children with cancer: A randomized, controlled trial. Iran J Psychiatry Behav Sci. 2020;14(4):e83110. [Google Scholar]
48.HAMID N, DEHGHANIZADEH Z, AEDI B. A study of the effect of religion-based cognitive-behavior therapy on depression in divorced women. Family Counseling and Psychotherapy. 2011;1(1):54–64. [Google Scholar]
49.Heidarian Fard Z, Bakhshipour B, Faramarzi M. The Effectiveness of Group Cognitive-behavioral Therapy on Social Anxiety, Social Self-efficacy and Rumination. Clinical Psychology Studies. 2016 Feb 20;6(21):152–72. [Google Scholar]
50.Hasar S, Nikdel F, Kharamin S. The effectiveness of cognitive-behavioral techniques training on procrastination, stress, anxiety and depression of high school female students. Armaghane Danesh. 2015;19(12):1105–17. [Google Scholar]
51.Hosseini Nik SS, Eslamzade A. The effectiveness of cognitive-behavioral therapy in reducing post-traumatic symptoms, quality of life, self-esteem and marital satisfaction in women with marital infidelity. Women Studies. 2019;10(27):53–71. [Google Scholar]
52.Isvand M, Baghouli H, Javidi HA. Comparing the effectiveness of cognitive behavioral therapy and acceptance and commitment therapy for rumination, psychological flexibility, resilience, and perceived stress among the women suffering from depression. Psychological Achievements. :2023. [Google Scholar]
53.Kamran F, Abbasi G, Hassanzadeh R. The effectiveness of cognitive-behavioral therapy on life satisfaction, future anxiety, and perceived stress in gifted students. Advances in Cognitive Science. 2024 Jan 10;25(4):33–47. [Google Scholar]
54.Keyvani R, Jahanian S. The effectiveness of cognitive-behavioral interventions on test anxiety, general health, and COVID-19 anxiety in university entrance exam candidates. Applied Research in Behavioral Sciences. 2022 Feb 20;13(50):63–87. [Google Scholar]
55.Khaledian M, Kamar Zarin H, Jalalian A. The effectiveness of group cognitive behavior therapy on reduction of addicts’ depression. Scientific Quarterly Research on Addiction. 2014;8(29):77–88. [Google Scholar]
56.Kochak Nia F. Effectiveness cognitive-behavioral therapy (CBT) on stress, dysfanctional and burnout among staff's of South West Region Army of the Islamic Republic of Iran. Nurse and Physician Within War. 2022;9(33):60–73. [Google Scholar]
57.Mami S, Soltany S, Ebrahimian S. Comparison of effectiveness of cognitive behavior therapy and dialectic behavior therapy on depression. Studies in Medical Sciences. 2015;26(9):793–801. [Google Scholar]
58.Mehrara M, Ghaffari Z, Mohammadian Ghezelghabr R, Ghavasi F, Fatemizadeh M. The effectiveness of cognitive-behavioral play therapy on pain tolerance and trait-state anxiety among children with leukemia cancer in Isfahan City. Int J Appl Behav Sci. 2018;5(2):22–7. doi: 10.22037/ijabs.v5i2.21652. [DOI] [Google Scholar]
59.Mikaeili Barzili N, Ahadi B, HasanAbadi H. The effect of islamic therapy and cognitive–behavioral therapy on patients with obsessive–compulsive disorder. Psychological Achievements. 2011;18(2):61–86. [Google Scholar]
60.Moghtader L, Hasanzade R, Mirzaeian B, Dusti Y. Comparison of the Effectiveness of Group Cognitive Behavioral Therapy and Group Cognitive Hypnotism for Anxiety in Women with Premenstrual Syndrome. Journal of Guilan University of Medical Sciences. 2015;24(94) [Google Scholar]
61.Mohammadian MM, AZADYEKTA M, JOMEHRI F. Comparing the Effectiveness of Group Therapy with Cognitive-Behavioral and Psychodrama Approaches on Reducing the Symptoms of Depression and Obsessive-Compulsive Disorder in 30-40 Years Old Women with These Disorders. 2022. [Google Scholar]
62.Mohammadnejad E, Keshavarzi Arshadi F, Hasani F. Comparison of the effectiveness of exposure and response prevention (ERP) with mindfulness-based cognitive-behavioral therapy (MBCBT) on obsessive-compulsive syndrome and depression in women with obsessive-compulsive disorder. Psychol Sci. 2021;20(108):2269–84. [Google Scholar]
63.Mohammadzadeh Farahani A, Naderi F, Ahadi A, Karaskian A. The effectiveness of cognitive-behavioral therapy on social anxiety and blood glucose control in children with type 1 diabetes mellitus. Journal of Psychological Achievements. 2016 Dec 21;23(2):91–112. [Google Scholar]
64.Monirpour N, Hasani SS. The Effectiveness of Cognitive-Behavioral Therapy with a Rational-Spiritual Approach on the Reduction of Symptoms of Obsessive Compulsive Disorder (OCD) among Women. 2019. [Google Scholar]
65.Narimani M, Taklavi S, Abolghasemi A, Mikaili N. The effectiveness of applied relaxation training based on mindfulness and cognitive-behavioral therapy on anxiety sensitivity of women with generalized anxiety disorder. J Clin Psychol. 2014;6(3):13–22. [Google Scholar]
66.Nikmorad A, Soltaninejad A, Anisi J, Panahi H, Kafrashi S, Barati HR, et al. Comparing the effectiveness of Eye Movement Desensitization and Reprocessing and Cognitive-Behavioral Therapy on reducing Post-Traumatic Stress Disorder in war veterans. J Police Med. 2013 Dec 22;7(2):240–8. [Google Scholar]
67.Nikneshan S, Golparvar M, Abedi A, NASRI P, FAMOURI F. The effectiveness of cognitive-behavioral play therapy (CBPT) and resiliency based play therapy on parenting stress in children with functional abdominal pain. 2020. [Google Scholar]
68.Norozi M, Mikaeeli Maniea F, Issazadegan A. Comparison of the Effectiveness of Cognitive Behavioral Group Therapy and Mindfulness and Acceptance-based Group Therapy in the Reduction of Social Anxiety Disorder. Journal of Modern Psychological Researches. 2017;11(44):199–232. [Google Scholar]
69.Nourisaeed A, Ghorban Shiroudi S, Salari A. The Effectiveness of Cognitive-Behavioral Therapy on Perceived Stress and Coping Skills in Patients after Myocardial Infarction. Clinical Psychology and Personality. 2022 Feb 20;19(2):81–90. [Google Scholar]
70.Omidi A, Mohammad Khani P, Poorshahbaz P, Dolatshahi A. Efficacy of combined cognitive behavior therapy and mindfulness based cognitive therapy in patients with major depressive disorder. Feyz Medical Sciences Journal. 2008;12(2):9–14. [Google Scholar]
71.Aziz MO, Mehrinejad SA, Hashemian K, Paivastegar M. Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complementary therapies in clinical practice. 2020 May 1;:101122–39. doi: 10.1016/j.ctcp.2020.101122. [DOI] [PubMed] [Google Scholar]
72.Parvandi A, Moradi A, Amirian M, Ahmadi E. Effectiveness of Cognitive-Behavioral Therapy Based on. Journal of Psychological Studies. 2022;18(2):77–90. [Google Scholar]
73.Pasandian S, Hashemi Razini H. The Effectiveness of Group Therepy with a Cognitive Behavioral Approach on Practical Obsessions Caused by the Covid-19 crisis. Clinical Psychology Achievements. 2021 ;7(3):31–42. [Google Scholar]
74.Khodabakhsh Pirkalani R, Taghavi KS, Rastgoo F. Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Neurofeedback Techniques on Women's Depression Adult. Clinical Psychology Studies. 2019 Oct 23;10(36):25–46. [Google Scholar]
75.Rajabi G, Shamoni Ahwazi S, Amanollahi A. The effect of group cognitive-behavior therapy on depression symptoms decrease in adolescence girls. Journal of Educational Psychology Studies. 2018 Mar 21;15(29):125–48. [Google Scholar]
76.Ranjbar F, Ashktorab T, Dadgari A. Effect of group cognitive-behavioral therapy on depression. SSU_Journals. 2010;18(3):299–306. [Google Scholar]
77.Rashed F, Imani S, Shokri O. The Effectiveness of Mindfulness-based Cognitive Therapy on Depression and Apathy among HIV-infected Women. Thought & Behavior in Clinical Psychology. 2021 Oct;16(61):31–46. https://sanad.iau.ir/Journal/jtbcp/Article/1202761 . [Google Scholar]
78.Rezaie F, Neshat Doost H, Vakili Zarch N, Amra B, Molavi H. Effectiveness of Cognitive Behavioral Therapy on Anxiety and Depression of Asthma Patients. Clinical psychology and personality. 2013;10(2):23–32. [Google Scholar]
79.Sadr Mohammadi R, Gholamrezaie S, Ghadampour E. The Comparison of the Effect of Memory Specificity Training, Behavioral Activation Treatment, and Cognitive Behavioral Therapy on Treatment-Resistant Depression. The Neuroscience Journal of Shefaye Khatam. 2019;8(1):31–41. [Google Scholar]
80.Saleh J, Mahmoudi O, Paydar M. Efficacy of cognitive-behavioral therapy on the reduction of depression among students. Quarterly Journal of Child Mental Health. 2015;2(1):83–8. [Google Scholar]
81.Salehi S, MOUSAVI SAM, Sarichloo MI, Ghafelebashi SH. The effectiveness of cognitive-behavioral therapy on patients with obsessive compulsive disorder. 2015. [Google Scholar]
82.Samavatyan H, Kalantari M, Aslipoor A, Abedi A. The effectiveness of parent–child cognitive behavioral therapy on emotional behavioral problems of grief children. Counseling Culture and Psycotherapy. 2021 Sep 23;12(47):195–220. [Google Scholar]
83.Sharifi M, Mohammad Aminzadeh D, Mehraban S. The effectiveness of Cognitive-behavioral group therapy on reducing separation anxiety in children with hearing impairment. Rooyesh-e-Ravanshenasi Journal (RRJ) 2021;10(3):47–54. [Google Scholar]
84.Manesh ZS, Gharamaleki NS, Narimani M. The effectiveness of cognitive-behavioral therapy of leahy and schema therapy of young on social anxiety disorder and specific symptoms related to it. 2016. [Google Scholar]
85.Soleimani M, Mohammadkhani P, Dolatshahi B, Alizadeh H, Overmann KA, Coolidge FL. A Comparative Study of Group Behavioral Activation and Cognitive Therapy in Reducing Subsyndromal Anxiety and Depressive Symptoms. Iran J Psychiatry. 2015;10(2):71–8. [PMC free article] [PubMed] [Google Scholar]
86.Soleimani Sefat E, Younesi SJ, Dadkhah A, Rostami M. Effectiveness of cognitive behavioral therapy training in reducing depression in visually impaired male students. Iranian Rehabilitation Journal. 2017;15(2):165–72. [Google Scholar]
87.Sotoudeh N, Behnaz B, Ghorbani R. Effects of cognitive therapy, drug therapy and combined therapy in improvement of major depression. Koomesh. 2011 Sep 14;13(1):114–9. [Google Scholar]
88.TAJERI B. The effectiveness of CBT on depression and anxiety among Methamphetamine addicts. 2016. [Google Scholar]
89.Torshizi J, TOOZANDEHJANI H, BAGHERZADEH GZ. Comparison of Effectiveness of Integrated Therapy of Electromagnetic with Modular Cognitive Behavioral Therapy on Clinical Symptoms of Obsessive Washing Disorder. 2021. [Google Scholar]
90.Varmzyar AR, Makvandi B, Seraj-Khorrami N, Moradi-Manesh F, Moradi N. The Effectiveness of Cognitive-Behavioral Therapy on the Social Anxiety, Rumination, and Psychological Well-Being of People with Depression Referred to the Integrated Health Centers: Randomized Clinical Trial. Journal of Research in Rehabilitation Sciences. 2021;17(1):9–17. [Google Scholar]
91.Yousefi N, Mohammadi F, Azizi A, Shams Esfand Abadi R. Comparing the Effectiveness of Classical Cognitive Behavioral Therapy and Enhancement-Based Cognitive Behavioral Therapy on Depression and Quality of Life in Depressed Women. Journal of Clinical Psychology. 2019 Nov 22;11(3):101–12. [Google Scholar]
92.Zamani N, Tavallaei M, Kahdouei S. Cognitive-behavioral play therapy in children with reactive attachment disorder: help reduce anxiety, impulsivity, bullying and antisocial behaviors. Journal of Advanced Pharmacy Education & Research| Oct-Dec. 2020;10(4):45–52. [Google Scholar]
93.Zargar Y, Besaknezhad S, Akhlaghi Jami L, Zemestani M. The comparison of the effectiveness of group training of social skills and group cognitive-behavior therapy in reducing social anxiety among students. Studies in Medical Sciences. 2014;25(3):172–81. [Google Scholar]
94.Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. bmj. 2003 Sep 4;327(7414):557–60. doi: 10.1136/bmj.327.7414.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
95.Asadi M, Shiralipour A, Shakouri Z, Mohammadkhani S. Meta-analysis of the effectiveness of cognitive behavioral therapy (CBT) in treating patients with obsessive-compulsive disorder (OCD) SSU_Journal. 2012;20(3):396–405. [Google Scholar]
96.Neshat Doost HT, Mehrabi HA, Mousav SG. The efficacy of Brief Cognitive-Behavioral Therapy in depression, suicidal thoughts and cognitive emotion regulation in women attempting suicide. Psychol Sci. 2021;20(106):1767–86. [Google Scholar]
97.Alipour R, Hadinafard H, Aflakseir A, Molazadeh J. Investigating the efficacy of aromatherapy-based mindfulness and cognitive behavioral therapy on improving depression symptoms. Journal of Psychological Science. 2023 Apr;22(121):55–70. [Google Scholar]
98.Beck JS. Cognitive behavior therapy: Basics and beyond. Guilford Publications; 2020. [Google Scholar]
99.Borenstein M, Hedges LV, Higgins JP, Rothstein HR. Introduction to meta-analysis. John wiley & sons; 2021. [Google Scholar]
100.Choi GJ, Kang H. Heterogeneity in meta-analyses: an unavoidable challenge worth exploring. Korean J Anesthesiol. 2025;78(4):301–14. doi: 10.4097/kja.25001. [DOI] [PMC free article] [PubMed] [Google Scholar]
101.Kayrouz R, Karin E, Staples L, Dear B, Nielssen O, Titov N. A review of the 257 meta-analyses of the differences between females and males in prevalence and risk, protective factors, and treatment outcomes for mental disorder. BMC Psychiatry. 2025;25(1):677. doi: 10.1186/s12888-025-06848-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
102.Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, et al. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015;34(10):971–82. doi: 10.1037/hea0000161. [DOI] [PMC free article] [PubMed] [Google Scholar]
103.Johnco CJ, Muir C, Stalley C, Wuthrich VM. Developmental differences in cognitive restructuring skill acquisition across the lifespan: age differences between children, adults and older adults, and the role of cognitive flexibility. Cognitive Therapy and Research. 2025:1–12. [Google Scholar]
104.Cuijpers P, Karyotaki E, Weitz E, Andersson G, Hollon SD, Van Straten A. The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. J Affect Disord. 2014;159:118–26. doi: 10.1016/j.jad.2014.02.026. [DOI] [PubMed] [Google Scholar]

[B1] 1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2022. [Google Scholar]

[B2] 2.Aslan IH, Dorey L, Grant JE, Chamberlain SR. Emotion regulation across psychiatric disorders. CNS Spectr. 2024;29(3):215–20. doi: 10.1017/S1092852924000270. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B3] 3.Dembek C, Mackie D, Modi K, Zhu Y, Niu X, Grinnell T. The economic and humanistic burden of bipolar disorder in adults in the United States. Ann Gen Psychiatry. 2023;22(1):13. doi: 10.1186/s12991-023-00440-7. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B4] 4.Javaid SF, Hashim IJ, Hashim MJ, Stip E, Samad MA, Ahbabi AA. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Current Psychiatry. 2023;30(1):44. [Google Scholar]

[B5] 5.Higgins C, Chambers JA, Major K, Durham RC. Healthcare costs and quality of life associated with the long-term outcome of anxiety disorders. Anxiety Stress Coping. 2021;34(2):228–41. doi: 10.1080/10615806.2020.1839731. [DOI] [PubMed] [Google Scholar]

[B6] 6.Island T. StatPearls Publishing; 2022 Jan. PMID[Google Scholar]; 2023. [Google Scholar]

[B7] 7.Essau CA, Lewinsohn PM, Lim JX, Ho MR, Rohde P. Incidence, recurrence and comorbidity of anxiety disorders in four major developmental stages. J Affect Disord. 2018;228:248–53. doi: 10.1016/j.jad.2017.12.014. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B8] 8.Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, et al. Epidemiology and Impact of Health Care Provider-Diagnosed Anxiety and Depression Among US Children. J Dev Behav Pediatr. 2018;39(5):395–403. doi: 10.1097/DBP.0000000000000571. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B9] 9.IsHak WW, Mirocha J, Dang J, Vanle B, Metrikin B, Tessema K, et al. Quality of Life and Functioning Impairments Across Psychiatric Disorders in Adults Presenting for Outpatient Psychiatric Evaluation and Treatment. Psychiatr Res Clin Pract. 2024;6(3):68–77. doi: 10.1176/appi.prcp.20230064. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B10] 10.Groen RN, Ryan O, Wigman JTW, Riese H, Penninx B, Giltay EJ, et al. Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks. BMC Med. 2020;18(1):308. doi: 10.1186/s12916-020-01738-z. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B11] 11.Mahoney AE, Hobbs MJ, Williams AD, Andrews G, Newby JM. The mediating relationship between maladaptive behaviours, cognitive factors, and generalised anxiety disorder symptoms. Behaviour Change. 2018;35(2):123–38. [Google Scholar]

[B12] 12.Vieira S, Liang X, Guiomar R, Mechelli A. Can we predict who will benefit from cognitive-behavioural therapy? A systematic review and meta-analysis of machine learning studies. Clin Psychol Rev. 2022;97:102193. doi: 10.1016/j.cpr.2022.102193. [DOI] [PubMed] [Google Scholar]

[B13] 13.Wallace DD, Carlson RG, Ohrt JH. Culturally adapted cognitive-behavioral therapy in the treatment of panic episodes and depression in an African American woman: a clinical case illustration. J Ment Health Couns. 2021;43(1):40–58. [Google Scholar]

[B14] 14.Carpenter JK, Andrews LA, Witcraft SM, Powers MB, Smits JAJ, Hofmann SG. Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depress Anxiety. 2018;35(6):502–14. doi: 10.1002/da.22728. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B15] 15.Cuijpers P, Quero S, Dowrick C, Arroll B. Psychological treatment of depression in primary care: recent developments. Curr Psychiatry Rep. 2019;21(12):129. doi: 10.1007/s11920-019-1117-x. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B16] 16.Li YN, Buys N, Ferguson S, Li ZJ, Sun J. Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease: A meta-analysis. World J Psychiatry. 2021;11(11):1147–66. doi: 10.5498/wjp.v11.i11.1147. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B17] 17.van Loenen I, Scholten W, Muntingh A, Smit J, Batelaan N. The Effectiveness of Virtual Reality Exposure-Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder: Meta-analysis. J Med Internet Res. 2022;24(2):e26736. doi: 10.2196/26736. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B18] 18.Öst LG, Enebrink P, Finnes A, Ghaderi A, Havnen A, Kvale G, et al. Cognitive behavior therapy for adult post-traumatic stress disorder in routine clinical care: A systematic review and meta-analysis. Behav Res Ther. 2023;166:104323. doi: 10.1016/j.brat.2023.104323. [DOI] [PubMed] [Google Scholar]

[B19] 19.Khanjani M, Pezhman A, Masoudi F, Taherian H. The effectiveness of cognitive behavioral therapy on depression and anxiety in patients with chronic disorders: a systematic review and meta-analysis of clinical trials in Iranian population. Clinical Psychology Achievements. 2025;11(2):13–32. [Google Scholar]

[B20] 20.Akbari M, Hosseini ZS. A meta-analysis of comparing the efficacy of the third wave of behavior therapies on depression in Iran: Comparing acceptance and commitment therapy, mindfulness-based therapy and metacognitive therapy (2001-2017) Clinical Psychology and Personality. 2020;17(1):175–89. [Google Scholar]

[B21] 21.Doyle C, Bhar S, Fearn M, Ames D, Osborne D, You E, et al. The impact of telephone‐delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: a randomized controlled trial. Br J Health Psychol. 2017;22(3):542–56. doi: 10.1111/bjhp.12245. [DOI] [PubMed] [Google Scholar]

[B22] 22.Li X, Laplante DP, Paquin V, Lafortune S, Elgbeili G, King S. Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev. 2022;92:102129. doi: 10.1016/j.cpr.2022.102129. [DOI] [PubMed] [Google Scholar]

[B23] 23.Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372 doi: 10.1136/bmj.n71. n71. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B24] 24.Mesrabadi J, Nasrolahi Y. Meta-analysis: concepts, software and reporting. Tabriz: Shahid Madani University Publication; 2016. [Google Scholar]

[B25] 25.Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. Bmj. 2019;366:l4898. doi: 10.1136/bmj.l4898. [DOI] [PubMed] [Google Scholar]

[B26] 26.Barker TH, Habibi N, Aromataris E, Stone JC, Leonardi-Bee J, Sears K, et al. The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies. JBI Evid Synth. 2024;22(3):378–88. doi: 10.11124/JBIES-23-00268. [DOI] [PubMed] [Google Scholar]

[B27] 27.Hedges LV, Pigott TD. The power of statistical tests in meta-analysis. Psychol Methods. 2001;6(3):203–17. [PubMed] [Google Scholar]

[B28] 28.Cohen J. Statistical power analysis for the behavioral sciences. routledge; 2013. [Google Scholar]

[B29] 29.Abdolghaderi M, Kafi S-M, Saberi A, Ariaporan S. Effectiveness of mindfulness-based cognitive therapy on hope and pain beliefs of patients with chronic low back pain. Assari S. Social Determinants of Delayed Gratification among American Children. Casp J Neurol Sci. 2020;6(3):181–9. doi: 10.32598/cjns.6.22.2. [DOI] [PubMed] [Google Scholar]

[B30] 30.Akbari J, Aghamohammadian H, Ghanbari B. Effectiveness of CBT, pharmacotherapy and combined approach in improvement of symptoms depression anger in borderline personality disorder. J Psychol. 2009;13(3):342–59. [Google Scholar]

[B31] 31.Akhondi YZ, Ghazanfari A, Sharifi T. Comparison of the Effectiveness of Transdiagnostic Treatment and Cognitive-Behavioral Therapy on the Anxiety and Depression of Depressed Women. 2024. [Google Scholar]

[B32] 32.Alamdarloo GH, Khorasani SM, Najafi M, Jabbari FS, Shojaee S. The effect of cognitive-behavioral therapy on depression, anxiety, and stress levels in Iranian males with addiction. Sage open. 2019;9(1):2158244018824466. [Google Scholar]

[B33] 33.Amir Soleimani L, Derakhshani F. Academic performance, cognitive behavioral therapy, social anxiety, students. Rooyesh-e-Ravanshenasi Journal (RRJ) 2024 Mar 10;13(1):161–70. [Google Scholar]

[B34] 34.Arab S, Mohammadi A. The Effectiveness of cognitive-behavioral therapy on sleep disorder and death anxiety in the elderly. Aging Psychology. 2023 May 5;9(1):102–89. [Google Scholar]

[B35] 35.Baghooli Kermani M, Nikrahan G R, Sadeghi M. The study of the effectiveness of cognitive behavioral therapy on depression and C-reactive protein in cardiac patients. Shenakht Journal of Psychology and Psychiatry. 2020 Sep 10;7(4):1–2. [Google Scholar]

[B36] 36.Bahadorzade M, Jajarmi M, Jalalabadi M, Eydi-Baygi M. Effectiveness of cognitive-behavioral group therapy on anxiety in addicts with successful cut off. Studies in Medical Sciences. 2015;25(11):961–7. [Google Scholar]

[B37] 37.Bahrami M, Khayatan F, Farhadi H, Aghaei A. The effectiveness of cognitive-behavioral therapy on children's anxiety in restructured families. Community Health Journal. 2019 Dec 22;13(4):44–53. [Google Scholar]

[B38] 38.Darvishi M, Zarei E, Hajalizadeh K. Efficiency of Cognitive-Behavioral Therapy on the Depression and Anxiety of the Veterans with Post-Traumatic Stress Disorder. Medical Journal of Mashhad university of Medical Sciences. 2021;64(4):3841–52. [Google Scholar]

[B39] 39.Daryabeigi M, Pourmohamdreza-Tajrishi M, Dolatshahi B, Bakhshi E. The effectiveness of cognitive-behavioral therapy on internalizing problems of children with externalizing disorders. Iranian Rehabilitation Journal. 2020;18(2):193–202. [Google Scholar]

[B40] 40.Daryayelal G, Akbari B. The effectiveness of Cognitive behavioral therapy on emotional processing in students with social anxiety disorder. Medical Journal of Mashhad university of Medical Sciences. 2022 Nov 22;65(5) [Google Scholar]

[B41] 41.Dehghani F, Neshat-Doust H, Molavi H, Nilforoushzadeh M. The effect of cognitive-behavioral stress management therapy on depression and anxiety of females with alopecia Areata. J Clin Psychol (Iran) 2009;1(2):1–9. [Google Scholar]

[B42] 42.Dehshiri GR. The effectiveness of cognitive-behavior therapy on anxiety and worry of people with generalized anxiety disorder. Journal of clinical psychology. 2012 Jun 21;4(2):19–28. [Google Scholar]

[B43] 43.Elahi M, Najafi M, Mohammadyfar MA. Comparison of the effectiveness of cognitive-behavioral therapy and metacognitive therapy on psychological distress (stress, anxiety, and depression) in drug addicts. Journal of Modern Psychological Researches. 2023 Sep 23;18(71):13–22. [Google Scholar]

[B44] 44.Ershadi Manesh S. A controlled comparison of the efficacy of creative problem solving therapy and cognitive behavioural therapy in adolescent'depression. Psychol Sci. 2021;20(100):485–501. [Google Scholar]

[B45] 45.Asadnia S, Issazadeghan A, Ansari B. Evaluation of the effectiveness of cognitive behavioral therapy on decreasing depression levels and improving the lifestyle of patients with type 2 diabetes. Studies in Medical Sciences. 2013;24(10):812–22. [Google Scholar]

[B46] 46.Gharashi K, Moheb N. The effect of cognitive-behavioral therapy on reducing the anxiety and depression of children with hearing loss. Auditory and Vestibular Research. 2018;27(1):31–7. [Google Scholar]

[B47] 47.Hamedi V, Hamid N, Beshlideh K, Marashi SA, Hashemi Sheikh Shabani SE. Effectiveness of conventional cognitive-behavioral therapy and its computerized version on reduction in pain intensity, depression, anger, and anxiety in children with cancer: A randomized, controlled trial. Iran J Psychiatry Behav Sci. 2020;14(4):e83110. [Google Scholar]

[B48] 48.HAMID N, DEHGHANIZADEH Z, AEDI B. A study of the effect of religion-based cognitive-behavior therapy on depression in divorced women. Family Counseling and Psychotherapy. 2011;1(1):54–64. [Google Scholar]

[B49] 49.Heidarian Fard Z, Bakhshipour B, Faramarzi M. The Effectiveness of Group Cognitive-behavioral Therapy on Social Anxiety, Social Self-efficacy and Rumination. Clinical Psychology Studies. 2016 Feb 20;6(21):152–72. [Google Scholar]

[B50] 50.Hasar S, Nikdel F, Kharamin S. The effectiveness of cognitive-behavioral techniques training on procrastination, stress, anxiety and depression of high school female students. Armaghane Danesh. 2015;19(12):1105–17. [Google Scholar]

[B51] 51.Hosseini Nik SS, Eslamzade A. The effectiveness of cognitive-behavioral therapy in reducing post-traumatic symptoms, quality of life, self-esteem and marital satisfaction in women with marital infidelity. Women Studies. 2019;10(27):53–71. [Google Scholar]

[B52] 52.Isvand M, Baghouli H, Javidi HA. Comparing the effectiveness of cognitive behavioral therapy and acceptance and commitment therapy for rumination, psychological flexibility, resilience, and perceived stress among the women suffering from depression. Psychological Achievements. :2023. [Google Scholar]

[B53] 53.Kamran F, Abbasi G, Hassanzadeh R. The effectiveness of cognitive-behavioral therapy on life satisfaction, future anxiety, and perceived stress in gifted students. Advances in Cognitive Science. 2024 Jan 10;25(4):33–47. [Google Scholar]

[B54] 54.Keyvani R, Jahanian S. The effectiveness of cognitive-behavioral interventions on test anxiety, general health, and COVID-19 anxiety in university entrance exam candidates. Applied Research in Behavioral Sciences. 2022 Feb 20;13(50):63–87. [Google Scholar]

[B55] 55.Khaledian M, Kamar Zarin H, Jalalian A. The effectiveness of group cognitive behavior therapy on reduction of addicts’ depression. Scientific Quarterly Research on Addiction. 2014;8(29):77–88. [Google Scholar]

[B56] 56.Kochak Nia F. Effectiveness cognitive-behavioral therapy (CBT) on stress, dysfanctional and burnout among staff's of South West Region Army of the Islamic Republic of Iran. Nurse and Physician Within War. 2022;9(33):60–73. [Google Scholar]

[B57] 57.Mami S, Soltany S, Ebrahimian S. Comparison of effectiveness of cognitive behavior therapy and dialectic behavior therapy on depression. Studies in Medical Sciences. 2015;26(9):793–801. [Google Scholar]

[B58] 58.Mehrara M, Ghaffari Z, Mohammadian Ghezelghabr R, Ghavasi F, Fatemizadeh M. The effectiveness of cognitive-behavioral play therapy on pain tolerance and trait-state anxiety among children with leukemia cancer in Isfahan City. Int J Appl Behav Sci. 2018;5(2):22–7. doi: 10.22037/ijabs.v5i2.21652. [DOI] [Google Scholar]

[B59] 59.Mikaeili Barzili N, Ahadi B, HasanAbadi H. The effect of islamic therapy and cognitive–behavioral therapy on patients with obsessive–compulsive disorder. Psychological Achievements. 2011;18(2):61–86. [Google Scholar]

[B60] 60.Moghtader L, Hasanzade R, Mirzaeian B, Dusti Y. Comparison of the Effectiveness of Group Cognitive Behavioral Therapy and Group Cognitive Hypnotism for Anxiety in Women with Premenstrual Syndrome. Journal of Guilan University of Medical Sciences. 2015;24(94) [Google Scholar]

[B61] 61.Mohammadian MM, AZADYEKTA M, JOMEHRI F. Comparing the Effectiveness of Group Therapy with Cognitive-Behavioral and Psychodrama Approaches on Reducing the Symptoms of Depression and Obsessive-Compulsive Disorder in 30-40 Years Old Women with These Disorders. 2022. [Google Scholar]

[B62] 62.Mohammadnejad E, Keshavarzi Arshadi F, Hasani F. Comparison of the effectiveness of exposure and response prevention (ERP) with mindfulness-based cognitive-behavioral therapy (MBCBT) on obsessive-compulsive syndrome and depression in women with obsessive-compulsive disorder. Psychol Sci. 2021;20(108):2269–84. [Google Scholar]

[B63] 63.Mohammadzadeh Farahani A, Naderi F, Ahadi A, Karaskian A. The effectiveness of cognitive-behavioral therapy on social anxiety and blood glucose control in children with type 1 diabetes mellitus. Journal of Psychological Achievements. 2016 Dec 21;23(2):91–112. [Google Scholar]

[B64] 64.Monirpour N, Hasani SS. The Effectiveness of Cognitive-Behavioral Therapy with a Rational-Spiritual Approach on the Reduction of Symptoms of Obsessive Compulsive Disorder (OCD) among Women. 2019. [Google Scholar]

[B65] 65.Narimani M, Taklavi S, Abolghasemi A, Mikaili N. The effectiveness of applied relaxation training based on mindfulness and cognitive-behavioral therapy on anxiety sensitivity of women with generalized anxiety disorder. J Clin Psychol. 2014;6(3):13–22. [Google Scholar]

[B66] 66.Nikmorad A, Soltaninejad A, Anisi J, Panahi H, Kafrashi S, Barati HR, et al. Comparing the effectiveness of Eye Movement Desensitization and Reprocessing and Cognitive-Behavioral Therapy on reducing Post-Traumatic Stress Disorder in war veterans. J Police Med. 2013 Dec 22;7(2):240–8. [Google Scholar]

[B67] 67.Nikneshan S, Golparvar M, Abedi A, NASRI P, FAMOURI F. The effectiveness of cognitive-behavioral play therapy (CBPT) and resiliency based play therapy on parenting stress in children with functional abdominal pain. 2020. [Google Scholar]

[B68] 68.Norozi M, Mikaeeli Maniea F, Issazadegan A. Comparison of the Effectiveness of Cognitive Behavioral Group Therapy and Mindfulness and Acceptance-based Group Therapy in the Reduction of Social Anxiety Disorder. Journal of Modern Psychological Researches. 2017;11(44):199–232. [Google Scholar]

[B69] 69.Nourisaeed A, Ghorban Shiroudi S, Salari A. The Effectiveness of Cognitive-Behavioral Therapy on Perceived Stress and Coping Skills in Patients after Myocardial Infarction. Clinical Psychology and Personality. 2022 Feb 20;19(2):81–90. [Google Scholar]

[B70] 70.Omidi A, Mohammad Khani P, Poorshahbaz P, Dolatshahi A. Efficacy of combined cognitive behavior therapy and mindfulness based cognitive therapy in patients with major depressive disorder. Feyz Medical Sciences Journal. 2008;12(2):9–14. [Google Scholar]

[B71] 71.Aziz MO, Mehrinejad SA, Hashemian K, Paivastegar M. Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complementary therapies in clinical practice. 2020 May 1;:101122–39. doi: 10.1016/j.ctcp.2020.101122. [DOI] [PubMed] [Google Scholar]

[B72] 72.Parvandi A, Moradi A, Amirian M, Ahmadi E. Effectiveness of Cognitive-Behavioral Therapy Based on. Journal of Psychological Studies. 2022;18(2):77–90. [Google Scholar]

[B73] 73.Pasandian S, Hashemi Razini H. The Effectiveness of Group Therepy with a Cognitive Behavioral Approach on Practical Obsessions Caused by the Covid-19 crisis. Clinical Psychology Achievements. 2021 ;7(3):31–42. [Google Scholar]

[B74] 74.Khodabakhsh Pirkalani R, Taghavi KS, Rastgoo F. Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Neurofeedback Techniques on Women's Depression Adult. Clinical Psychology Studies. 2019 Oct 23;10(36):25–46. [Google Scholar]

[B75] 75.Rajabi G, Shamoni Ahwazi S, Amanollahi A. The effect of group cognitive-behavior therapy on depression symptoms decrease in adolescence girls. Journal of Educational Psychology Studies. 2018 Mar 21;15(29):125–48. [Google Scholar]

[B76] 76.Ranjbar F, Ashktorab T, Dadgari A. Effect of group cognitive-behavioral therapy on depression. SSU_Journals. 2010;18(3):299–306. [Google Scholar]

[B77] 77.Rashed F, Imani S, Shokri O. The Effectiveness of Mindfulness-based Cognitive Therapy on Depression and Apathy among HIV-infected Women. Thought & Behavior in Clinical Psychology. 2021 Oct;16(61):31–46. https://sanad.iau.ir/Journal/jtbcp/Article/1202761 . [Google Scholar]

[B78] 78.Rezaie F, Neshat Doost H, Vakili Zarch N, Amra B, Molavi H. Effectiveness of Cognitive Behavioral Therapy on Anxiety and Depression of Asthma Patients. Clinical psychology and personality. 2013;10(2):23–32. [Google Scholar]

[B79] 79.Sadr Mohammadi R, Gholamrezaie S, Ghadampour E. The Comparison of the Effect of Memory Specificity Training, Behavioral Activation Treatment, and Cognitive Behavioral Therapy on Treatment-Resistant Depression. The Neuroscience Journal of Shefaye Khatam. 2019;8(1):31–41. [Google Scholar]

[B80] 80.Saleh J, Mahmoudi O, Paydar M. Efficacy of cognitive-behavioral therapy on the reduction of depression among students. Quarterly Journal of Child Mental Health. 2015;2(1):83–8. [Google Scholar]

[B81] 81.Salehi S, MOUSAVI SAM, Sarichloo MI, Ghafelebashi SH. The effectiveness of cognitive-behavioral therapy on patients with obsessive compulsive disorder. 2015. [Google Scholar]

[B82] 82.Samavatyan H, Kalantari M, Aslipoor A, Abedi A. The effectiveness of parent–child cognitive behavioral therapy on emotional behavioral problems of grief children. Counseling Culture and Psycotherapy. 2021 Sep 23;12(47):195–220. [Google Scholar]

[B83] 83.Sharifi M, Mohammad Aminzadeh D, Mehraban S. The effectiveness of Cognitive-behavioral group therapy on reducing separation anxiety in children with hearing impairment. Rooyesh-e-Ravanshenasi Journal (RRJ) 2021;10(3):47–54. [Google Scholar]

[B84] 84.Manesh ZS, Gharamaleki NS, Narimani M. The effectiveness of cognitive-behavioral therapy of leahy and schema therapy of young on social anxiety disorder and specific symptoms related to it. 2016. [Google Scholar]

[B85] 85.Soleimani M, Mohammadkhani P, Dolatshahi B, Alizadeh H, Overmann KA, Coolidge FL. A Comparative Study of Group Behavioral Activation and Cognitive Therapy in Reducing Subsyndromal Anxiety and Depressive Symptoms. Iran J Psychiatry. 2015;10(2):71–8. [PMC free article] [PubMed] [Google Scholar]

[B86] 86.Soleimani Sefat E, Younesi SJ, Dadkhah A, Rostami M. Effectiveness of cognitive behavioral therapy training in reducing depression in visually impaired male students. Iranian Rehabilitation Journal. 2017;15(2):165–72. [Google Scholar]

[B87] 87.Sotoudeh N, Behnaz B, Ghorbani R. Effects of cognitive therapy, drug therapy and combined therapy in improvement of major depression. Koomesh. 2011 Sep 14;13(1):114–9. [Google Scholar]

[B88] 88.TAJERI B. The effectiveness of CBT on depression and anxiety among Methamphetamine addicts. 2016. [Google Scholar]

[B89] 89.Torshizi J, TOOZANDEHJANI H, BAGHERZADEH GZ. Comparison of Effectiveness of Integrated Therapy of Electromagnetic with Modular Cognitive Behavioral Therapy on Clinical Symptoms of Obsessive Washing Disorder. 2021. [Google Scholar]

[B90] 90.Varmzyar AR, Makvandi B, Seraj-Khorrami N, Moradi-Manesh F, Moradi N. The Effectiveness of Cognitive-Behavioral Therapy on the Social Anxiety, Rumination, and Psychological Well-Being of People with Depression Referred to the Integrated Health Centers: Randomized Clinical Trial. Journal of Research in Rehabilitation Sciences. 2021;17(1):9–17. [Google Scholar]

[B91] 91.Yousefi N, Mohammadi F, Azizi A, Shams Esfand Abadi R. Comparing the Effectiveness of Classical Cognitive Behavioral Therapy and Enhancement-Based Cognitive Behavioral Therapy on Depression and Quality of Life in Depressed Women. Journal of Clinical Psychology. 2019 Nov 22;11(3):101–12. [Google Scholar]

[B92] 92.Zamani N, Tavallaei M, Kahdouei S. Cognitive-behavioral play therapy in children with reactive attachment disorder: help reduce anxiety, impulsivity, bullying and antisocial behaviors. Journal of Advanced Pharmacy Education & Research| Oct-Dec. 2020;10(4):45–52. [Google Scholar]

[B93] 93.Zargar Y, Besaknezhad S, Akhlaghi Jami L, Zemestani M. The comparison of the effectiveness of group training of social skills and group cognitive-behavior therapy in reducing social anxiety among students. Studies in Medical Sciences. 2014;25(3):172–81. [Google Scholar]

[B94] 94.Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. bmj. 2003 Sep 4;327(7414):557–60. doi: 10.1136/bmj.327.7414.557. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B95] 95.Asadi M, Shiralipour A, Shakouri Z, Mohammadkhani S. Meta-analysis of the effectiveness of cognitive behavioral therapy (CBT) in treating patients with obsessive-compulsive disorder (OCD) SSU_Journal. 2012;20(3):396–405. [Google Scholar]

[B96] 96.Neshat Doost HT, Mehrabi HA, Mousav SG. The efficacy of Brief Cognitive-Behavioral Therapy in depression, suicidal thoughts and cognitive emotion regulation in women attempting suicide. Psychol Sci. 2021;20(106):1767–86. [Google Scholar]

[B97] 97.Alipour R, Hadinafard H, Aflakseir A, Molazadeh J. Investigating the efficacy of aromatherapy-based mindfulness and cognitive behavioral therapy on improving depression symptoms. Journal of Psychological Science. 2023 Apr;22(121):55–70. [Google Scholar]

[B98] 98.Beck JS. Cognitive behavior therapy: Basics and beyond. Guilford Publications; 2020. [Google Scholar]

[B99] 99.Borenstein M, Hedges LV, Higgins JP, Rothstein HR. Introduction to meta-analysis. John wiley & sons; 2021. [Google Scholar]

[B100] 100.Choi GJ, Kang H. Heterogeneity in meta-analyses: an unavoidable challenge worth exploring. Korean J Anesthesiol. 2025;78(4):301–14. doi: 10.4097/kja.25001. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B101] 101.Kayrouz R, Karin E, Staples L, Dear B, Nielssen O, Titov N. A review of the 257 meta-analyses of the differences between females and males in prevalence and risk, protective factors, and treatment outcomes for mental disorder. BMC Psychiatry. 2025;25(1):677. doi: 10.1186/s12888-025-06848-7. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B102] 102.Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, et al. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015;34(10):971–82. doi: 10.1037/hea0000161. [DOI] [PMC free article] [PubMed] [Google Scholar]

[B103] 103.Johnco CJ, Muir C, Stalley C, Wuthrich VM. Developmental differences in cognitive restructuring skill acquisition across the lifespan: age differences between children, adults and older adults, and the role of cognitive flexibility. Cognitive Therapy and Research. 2025:1–12. [Google Scholar]

[B104] 104.Cuijpers P, Karyotaki E, Weitz E, Andersson G, Hollon SD, Van Straten A. The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. J Affect Disord. 2014;159:118–26. doi: 10.1016/j.jad.2014.02.026. [DOI] [PubMed] [Google Scholar]

PERMALINK

The Effects of Cognitive Behavioral Therapy Interventions on Emotional Disorders in Iranian Studies: A Systematic Review and Meta-Analysis

Leila Mirzaei

Zahra Golizade

Abolfazl Farid

Abstract

Materials and Methods

Figure 1.