Economic evaluation of psychiatric rehabilitation/self-management intervention (PPEP4All) compared with usual care in patients with Persistent Depressive Disorder (PDD) and their partner; a multicenter pragmatic randomized controlled trial.

Chronic depression (more than 2 years depressed) is a common psychiatric
disorder which is difficult to treat. Usual care is mostly individual,
including psychopharmacotherapy and/or psychotherapy and psychiatric nurse
guidance. If treatment outcome is insufficient, then psychiatric rehabilitation
is indicated according to the guideline: this project concerns psychiatric
rehabilitation, in which the partner of the patient (or significant other) is
involved in the treatment by means of a partnergroup or individual partner
sessions (PPEP4AII: "Patient and Partner Education Program for All chronic
diseases"). There is clinical evidence for PPEP4All but its cost-effectiveness
has not been investigated yet, which is the aim of the present project. In
mental health care is an urgent need for costeffective and easy-to-implement
treatment protocols for rehabilitation in chronic depression.

Objective/research question: What are costs and effects of group-oriented
Psychiatric Rehabilitation ("Patient and Partner Education Program for All
chronic diseases": PPEP4AII) in patients with Persistent Depressive Disorder
and their partner (or significant other), compared to Usual care?
Hypothesis is as follows: Compared to Usual care, PPEP4AII will cost less, lead
to better quality of life/functioning, fewer psychological symptoms, more
resilience, less chronic disease burden.

Multicenter Pragmatic Randomised Controlled Trial (superiority design).

PPEP4AII includes 10 weekly cognitive-behavioral group sessions of
Rehabilitation for patients with a separate partner group. PPEP4All can be
given in a group or in individual one-on-one sessions. In accordance with the
COVID-19 measures, we will ensure that the PPEP4All is offered in a safe
environment, for example, PPEP4All online over video-calling.

No risks are involved, and the burden for patients is minimal: 6 brief
questionnaires during 4 assessments (1 year) by the researcher at the 4 mental
health care centres. Assessment time points are as follows: T1/baseline,
T2/posttreatment at 3 months, T3/follow-up at 6 months, T4/follow-up at 12
months. There is no somatic assessment involved, and no somatic or
psychological discomfort is expected.