[Correspondence] Behavioural activation training for depression

We read with interest the article by David A Richards and colleagues1 on the effectiveness of behavioural activation (BA) for the treatment of depression as compared to cognitive-behavioural therapy (CBT) and were puzzled by the absence of any mention in the article of the limitations of non-inferiority designs. The authors emphasise the comparable effectiveness and safety, and the lower cost of BA versus CBT, without questioning the assay sensitivity of their study and the risk that, in their particular trial, both interventions might have been not equally effective, but equally ineffective.

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