A mobile app designed to provide cognitive behavioral therapy (CBT) tailored to people with obsessive-compulsive disorder (OCD) is effective in reducing symptoms while boosting patient adherence to treatment, according to a study presented here at the 2019 Annual Meeting of the Anxiety and Depression Association of America (ADAA).

"This technology could transform clinical care for some individuals with OCD," said Marina Gershkovich, PhD, New York State Psychiatric Institute at Columbia University Medical Center, New York, New York.

In an effort to bring CBT to patients with OCD in a more resource-efficient manner, Dr. Gershkovich and colleagues developed a mobile app that allows patients to customise their fear hierarchies and set reminders. It also assists with ritual prevention, and can collect real-time data for the patient to track.

The team then enrolled 23 adults with OCD (73% female) into a pilot study that included regular prompts from the app as well as therapist support with up to 5 in-person exposure/response therapy sessions weekly for 90 minutes, in addition to brief weekly phone calls.

After 8 weeks, patients showed significant changes in clinical symptoms, as assessed on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS; P< .001). There were also improvements on the Quality of Life Satisfaction Questionnaire (QLESQ; P = .08) and Depression and Anxiety Stress Scale (DASS; P = .09).

Post-hoc comparisons suggest improvements in OCD symptoms and an improvement in quality of life on primary outcome measures from baseline to post-treatment (YBOCS, post-hoc paired t-test, P< .001; Q-LESQ; P =.02).

"Mobile apps are particularly well suited for [the] integration of exposure and response prevention, because the most reliable predictor of response is patient adherence to between-session assignments, which can be facilitated and reinforced by the app," the authors concluded.

The program had an 87% completion rate with high satisfaction ratings.

The next steps include identifying patient characteristics that are most associated with symptom reduction, and determining which aspects of the program are most effective.

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