effect (RR=5.40, 95% CI: 2.86, 10.22, z=5.18, p<0.001) with minimal heterogeneity [Q(6)=6.43, p=0.38, I2=6.63%] among non-active comparison trials. For active comparison trials, a large effect was observed (RR=2.05, 95% CI: 1.46, 2.88, z=4.16, p<0.001), with minimal heterogeneity [Q(2)=0.39 p=0.83, I2=0%]. Visual inspection of the funnel plot and Egger’s test for bias indicated that publication bias may be present (t=11.25, p=0.06). When Duval and Tweedie’s trim-and-fill method was applied, two studies were trimmed and CBT still exhibited a moderate significant effect (RR=1.94, 95%CI: 1.43, 2.64).
