Tertiary endpoints are three measurements of psychosocial remission defined as a WHO-5 score of > 49, an SCL-10 score of < 26 and an mSDS score of < 10. Additional tertiary clinical endpoints are changes in wellness (WHO-5), disability (mSDS), and symptomatology on the Brief Symptom Inventory 18 (BSI-18) and the SCL-10.
Two questionnaires assessing the negative effects of psychological and antidepressant treatment will be sent at the first follow-up, at the end of the treatment package. We use the Patient-Reported Inventory of Side-Effects (PRISE), originally developed and validated in Danish and also used in the STAR*D trial [71 (link), 73 (link)]. The questionnaire is omitted if the patient has not been or is not on antidepressant medication. We use the short 20-item form of the Negative Effects Questionnaire (NEQ) to assess adverse and unwanted events in psychological treatment, i.e., new symptoms, dependency, stigma, hopelessness, and the experienced quality of treatment [74 (link), 75 (link)]. Both baseline characteristics and treatment experiences, e.g., negative effects on the NEQ, will be used to investigate reasons for CBT and treatment package drop-out.