Table [1]: Definition of reported outcomes Study outcome Definitions Adverse events Treatment side effect Depression severity and Change in depression symptoms from baseline using depression standardized treatment efficacy scale (PHQ-9 ,Beck Depression Inventory (BDI),BDI for primary care, Zung Self-Rating Depression Scale (SDS),Center for Epidemiologic Studies- Depression Scale (CES-D),Center for Epidemiologic Studies-Depression Scale (CES-D), Montgomery-Asberg Depression Rating Scale (MADRS), Minnesota Multiphasic Personality Inventory (MMPI), depression symptoms improvement. Dropout rate Percentage of patients who dropout from each treatment arm. Clinical Response ≥30%depression improvement (from baseline to endpoint). Remission Scores lower than 8 in the HAMD or more than 70% depression improvement. Relapse rate Return of symptoms to the full syndrome criteria for an episode during remission. Table[2]: Characteristics of the systematic reviews Author, year Studies Study Population/ country Interventions Comparison Outcome Alyson 201220 23 RCTs 211 patients / NR Group CBT Control -Depression severity measured by any standardized Scale Almeida 201521 11 RCTs Patients with depression Naturopathic Control -Depression (6 studies symptoms / NR severity measured included into by any our analysis) standardized Scale Amick 201522 11 RCTs Canada, Germany, England, AD CBT - Depression (6 studies Iran, Romania and United States severity measured included into by any our analysis) standardized scale -Response -Remission Arnberg 201423 40 RCTs 260 patients were included CCBT WL -Depression (only three Switzerland, Australia, Sweden severity measured studies were by any included to standardized our analysis) scale Berlim 201424 29 RCTS Subjects aged 18–75 years Biological Control -Response (only 17 with a diagnosis of primary MD/ intervention -Remission rates studies were NR -drop-out included to rates our analysis) Bower 201125 9 RCTS Participants (age 18+) with Psychotherapy -AD -Depression (only three depression. -CBT severity measured studies were All studies in the UK. -Control by any included to standardized our analysis) scale Cramer 201326 9 RCTS 348 Adults with depressive Physical activity Usual care -Depression Author, year Studies Study Population/ country Interventions Comparison Outcome (only 6studies disorders, with median age 33.7 severity measured were included years.76.5% of included by any to our participant were female. standardized analysis) India, Japan, USA, UK, Iran scale - Remission Churchill 200127 92 RCTs USA, UK, Canada, Australia -Psychotherapy Control -Depression -CBT severity measured -IPT by any -Psychodynamic standardized therapy Scale. -Dropouts -Recovery Cuijpers 200828 30 RCTS United States, Canada, United Psychotherapy AD - Depression (11 included Kingdom, and Mexico. severity measured in our by any anlaysis) standardized Scale -dropout rate Cuijpers 201029 16 RCTS 241 patients, In most studies the -CBT -IPT -Depression (only 6studies majority of patients was female - Psychotherapy -AD severity measured were included and married, age ranged -Control by any to our between 30 and 50/ NR standardized analysis) Scale Danielsson 14 RCT's 1,139 participants with major Physical activity -AD -Depression 201330 depression were followed in the -control severity measured 14 studies (12 separate trials by any plus two long term follow-ups). standardized Age ranged from 18-77 years scale old. Six trials were conducted in the USA, two in Great Britain, one in Portugal, one in Italy, one in New Zealand and one in Denmark. De Maat 200631 10 RCTS 532 patients / NR CBT AD -Dropout Author, year Studies Study Population/ country Interventions Comparison Outcome (only two -Relapse studies were -Remission included to our analysis) De Souza Moura 13 RCTs Studies population 28.6% were Physical activity -AD -Depression 201532 men, 85% had mild to moderate -Control severity measured depression, and only 15% had by any moderate to severe depression./ standardized NR scale Driessen 201033 23 RCTS 345 patients /NR Psychotherapy CBT -Depression (only four severity measured studies were by any included to standardized our analysis) scale Ekers 200834 20 RCTs 1088 subjects / CBT Control -Depression 17 in USA, 2 in UK and severity measured Australia, 1 in Spain, Canada, by any Netherland, Sweden and Iran standardized Hees 201335 8 RCTs 1233 patients, all patients were IPT -Psychotherapy -Depression diagnosed with non-psychotic -CBT severity measured MDD as a primary diagnosis. -Combined by any One study was carried out in the treatment standardized Netherlands, one in New Pharmacotherapy scale Zealand, one in Canada, one in the UK, one in Germany and three in the USA Hunot 201336 2 RCTs 56 female participants (mean Acceptance and CBT -Depression age of 43.17) with depression. Commitment severity measured All participants were from USA. Therapy (ACT) by any standardized scale Jakobsen 201137 12 RCTs 669 participants/ NR CT Control -Depression (19 severity measured publication) by any standardized Author, year Studies Study Population/ country Interventions Comparison Outcome scale -Remission Jakobsen 201238 19 RCTS 741 participants/ NR CT IPT -Depression (only seven severity measured studies were by any included to standardized our analysis) scale -Remission Lai 201239 4RCTS 80 patients/ Poland. Naturopathic Control -Depression ( 2 studies intervention severity measured were included by any to our standardized analysis) scale Linde 200540 37 RCTs 2 Austria, 1 Switzerland, 2 UK, Naturopathic -AD -Depression 4 USA, 1 France, 2 Sweden, 1 intervention -Control severity measured Canada, 1 Denmark, 26 by any Germany standardized scale Linde 200941 29 RCTs Eighteen trials were from Naturopathic -AD -Depression German-speaking countries, four intervention -Control severity measured from the US, two from the UK, by any and one each from Brazil, standardized Canada, Denmark, France and scale Sweden. -Response rate Liu 201542 30 RCTs Patients with mild to severe Physical activity Control -Reduction in (6 studies depression / NR depressive included into symptoms post- our analysis) treatment Mead 200943 29 RCTS 907 adult patients aged 18 and Physical activity Control -Reduction in (only 23 over with depression./ NR depressive studies were symptoms post- included to treatment our analysis) Mukai 201344 7 RCTS 78 patients, 41 Inositol with Inositol Placebo Efficacy Author, year Studies Study Population/ country Interventions Comparison Outcome (only two mean age of 47.92, and 37 response rate studies were Placebo with mean age of 50.58 included to years. our analysis) Both studies were done in Israel Okumura 201445 34 RCTS NR CBT Control Depression (only 25 severity measured studies were by any included to standardized our analysis) scale Richards 201246 23 RCTS 2327 patients were included. Computerized CBT -Depression (only 11 6 Netherlands, 3 Australia, 1 Cognitive Behavior Control severity measured studies were Sweden and 1 UK Therapy (CCBT) by any included to standardized our analysis) scale Ren 201547 26 RCTs Studies conducted in Iran and Naturopathic AD - Depression (12 studies China intervention severity measured included into by any our analysis) standardized Scale -Side effect Shaffer 201448 7 RCTS 149 patients/ age range (18-65) Naturopathic Control -Depression (only 2 studies / Iran. interventions severity measured were included by any to our standardized analysis) scale Shiozawa 201449 7 RCTs (259 patients) were included, the Biological Sham -Depression mean age was of 43.62yr interventions severity measured and 58.2% of participants were by any women. Patients presented a standardized moderate degree of treatment- scale resistant / NR -Response -Remission Stub 201150 26 RCTs Western countries, china Biological -AD -Depression intervention -Control severity measured by any Author, year Studies Study Population/ country Interventions Comparison Outcome standardized scale The UK ECT 73 RCT NR Biological -AD -Depression Review Group intervention -Control severity measured 200351 by any standardized Scale. Yeung 201452 21 RCTS 2575 patients with depression Naturopathic -AD -Depression (only 17 China, Iran intervention -Control severity measured studies were by any included to standardized our analysis) Scale. Yin 201453 35 RCTS 19 RCTs used Tai Chi on Physical activity Control -Depression (only 31 depressed patients, and 12 used severity measured studies were quigong/ NR by any included to standardized our analysis) Scale. Zhang 201054 146 RCTS 1998 patients with major Naturopathic -AD -Depression (only 20 depression / NR intervention -Control severity measured studies were by any included to standardized our analysis) Scale -Response rate severity of depression *NR: Not reported Figure [1-(A)]: Forest plot of Severity of depression (measured using standardized measurement instrument): Cognitive behavioral therapy (CBT) vs. (Anti- depressant medication, control, interpersonal psychotherapy and psychotherapy): Figure [1-(B)]: Forest plot of Severity of depression (measured using standardized measurement instrument): psychodynamic therapy vs. cognitive behavioral therapy: Figure [1-(C)]: Forest plot of Severity of depression (measured using standardized measurement instrument): Acceptance therapy vs. cognitive behavioral therapy: Figure [2]: Forest plot of Severity of depression (measured using standardized measurement instrument): computerized cognitive behavioral therapy (CCBT) vs. control treatment: Figure [3]: Forest plot of Severity